In Print Preview make sure page is set to 100 % to ensure printed version of application is legible. Applications can be sent to GNH by Mail, Fax, or Email.
Directions to ensure page is at 100 %
1 Right mouse
click or click on the icon at the top of the screen that reads FILE
2 Scroll to print preview
3 Click print preview
4 In this
window there is a drop down box with an arrow that will allow you to
select page size the default setting is shrink to fit
change this to 100% 
Hit the
down arrow to change the setting.
5 Click print and your application is ready to be filled out.
After we review your application we will contact you. To follow up on application status feel free to contact us at 1-800-329-8113.
Po Box 204
Farmington PA 15437
Phone: 800-329-8113
Fax: 724-329-8314
Email: gnh@qcol.net
Please be advised that GNH Trucking Inc. requires the following to be reviewed and signed by all new employees.
Hiring Guidelines
Drivers must be at least 24 years of age.
Drivers must have at the least 2 years of commercial driving experience.
Any driver with more than two major violations in a three year period will be terminated.
Accidents will be reviewed and action will be taken on an individual basis.
John Philip Holt
CEO
__________________ ____________________
Driver signature Date
Application For Employment
Company________________________________ Address_________________________
________________________________________________________________________
City, State, Zip_____________________________________________________________________________________________________________________________________________
Name___________________________________________________________________
First Middle Last
Date of Birth________________________________ SS#_________________________
Address for Past Three Years
________________________________________________________________________
Street City State Zip
________________________________________________________________________
Street City State Zip
________________________________________________________________________
Street City State Zip
________________________________________________________________________
Street City State Zip
Attach sheet if more space is needed.
Experience and Qualifications-Driver
Driver’s License Number ___________________________________________________
State_____________________ Expiration date.______________ Class/Type__________
Have you ever been denied a license or permit, or privilege to operate a motor vehicle? Yes ________ No _________
Has any license, permit or privilege suspended or revoked? Yes _________No_________
If you answered yes to any of the following Questions please give details.
__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________. I
Have you ever tested positive or refused controlled substance testing for any company which you did not accept a driving position? Yes _________ No __________
Driving Experience
Class of Equipment Type of equipment Dates Approx Miles
Van,Tank,Flat,ect. From To Total
Straight truck _______________ ________________ ___________
Class of Equipment Type of equipment Dates Approx Miles
Van,Tank,Flat,ect. From To Total
Straight truck _______________ ________________ ___________
Class of Equipment Type of equipment Dates Approx Miles
Van,Tank,Flat,ect. From To Total
Straight truck _______________ ________________ ___________
Employment Record
Please fill in complete addresses. Attach Sheet if more space is needed.
NOTE DOT requires that employment for at least 3 years and/ or Commercial Driving Experience
For the past ten years to be shown.
Employer
Name __________________________________
Address _________________________________City _______________State _____ Zip ________
Position Held ______________________________ From ______________ To ________________
Employed in a Safety Sensitive Function _____ Yes _____ No Subject to FMCSR____ Yes ____ No
Reason for Leaving _________________________________________________________________
Position Held _____________________________Salary, Wage _____________________________
Contact person____________________________ Phone # _________________________________
Employer
Name __________________________________
Address _________________________________City _______________State _____ Zip ________
Position Held ______________________________ From ______________ To ________________
Employed in a Safety Sensitive Function _____ Yes _____ No Subject to FMCSR____ Yes ____ No
Reason for Leaving _________________________________________________________________
Position Held _____________________________Salary, Wage _____________________________
Contact person____________________________ Phone # _________________________________
Employer
Name __________________________________
Address _________________________________City _______________State _____ Zip ________
Position Held ______________________________ From ______________ To ________________
Employed in a Safety Sensitive Function _____ Yes _____ No Subject to FMCSR____ Yes ____ No
Reason for Leaving _________________________________________________________________
Position Held _____________________________Salary, Wage _____________________________
Contact person____________________________ Phone # _________________________________
Employer
Name __________________________________
Address _________________________________City _______________State _____ Zip ________
Position Held ______________________________ From ______________ To ________________
Employed in a Safety Sensitive Function _____ Yes _____ No Subject to FMCSR____ Yes ____ No
Reason for Leaving _________________________________________________________________
Position Held _____________________________Salary, Wage _____________________________
Contact person____________________________ Phone # _________________________________
Employer
Name __________________________________
Address _________________________________City _______________State _____ Zip ________
Position Held ______________________________ From ______________ To ________________
Employed in a Safety Sensitive Function _____ Yes _____ No Subject to FMCSR____ Yes ____ No
Reason for Leaving _________________________________________________________________
Position Held _____________________________Salary, Wage _____________________________
Contact person____________________________ Phone # _________________________________
Employer
Name __________________________________
Address _________________________________City _______________State _____ Zip ________
Position Held ______________________________ From ______________ To ________________
Employed in a Safety Sensitive Function _____ Yes _____ No Subject to FMCSR____ Yes ____ No
Reason for Leaving _________________________________________________________________
Position Held _____________________________Salary, Wage _____________________________
Contact person____________________________ Phone # _________________________________
Employer
Name __________________________________
Address _________________________________City _______________State _____ Zip ________
Position Held ______________________________ From ______________ To ________________
Employed in a Safety Sensitive Function _____ Yes _____ No Subject to FMCSR____ Yes ____ No
Reason for Leaving _________________________________________________________________
Position Held _____________________________Salary, Wage _____________________________
Contact person____________________________ Phone # _________________________________
Employer
Name __________________________________
Address _________________________________City _______________State _____ Zip ________
Position Held ______________________________ From ______________ To ________________
Employed in a Safety Sensitive Function _____ Yes _____ No Subject to FMCSR____ Yes ____ No
Reason for Leaving _________________________________________________________________
Position Held _____________________________Salary, Wage _____________________________
Contact person____________________________ Phone # _________________________________
Employer
Name __________________________________
Address _________________________________City _______________State _____ Zip ________
Position Held ______________________________ From ______________ To ________________
Employed in a Safety Sensitive Function _____ Yes _____ No Subject to FMCSR____ Yes ____ No
Reason for Leaving _________________________________________________________________
Position Held _____________________________Salary, Wage _____________________________
Contact person____________________________ Phone # _________________________________
Employer
Name __________________________________
Address _________________________________City _______________State _____ Zip ________
Position Held ______________________________ From ______________ To ________________
Employed in a Safety Sensitive Function _____ Yes _____ No Subject to FMCSR____ Yes ____ No
Reason for Leaving _________________________________________________________________
Position Held _____________________________Salary, Wage _____________________________
Contact person____________________________ Phone # _________________________________
Employer
Name __________________________________
Address _________________________________City _______________State _____ Zip ________
Position Held ______________________________ From ______________ To ________________
Employed in a Safety Sensitive Function _____ Yes _____ No Subject to FMCSR____ Yes ____ No
Reason for Leaving _________________________________________________________________
Position Held _____________________________Salary, Wage _____________________________
Contact person____________________________ Phone # _________________________________
Employer
Name __________________________________
Address _________________________________City _______________State _____ Zip ________
Position Held ______________________________ From ______________ To ________________
Employed in a Safety Sensitive Function _____ Yes _____ No Subject to FMCSR____ Yes ____ No
Reason for Leaving _________________________________________________________________
Position Held _____________________________Salary, Wage _____________________________
Contact person____________________________ Phone # _________________________________
Traffic Convictions And Forfeitures For The Past Three Years
Location Date Charge Penalty
_______________ ___________ ________________ ___________________
_______________ ___________ ________________ ___________________
_______________ ___________ ________________ ___________________
_______________ ___________ ________________ ___________________
_______________ ___________ ________________ ___________________
Personal References
List three other than relatives
Name ____________________ Phone ________________ How Long Known _______
Name ____________________ Phone ________________ How Long Known _______
Name ____________________ Phone ________________ How Long Known _______
This verifies that this application was completed by me and that all entries and information in it are true and complete to the best of my knowledge.
___________________________________ ___________________________
Applicant Signature Date
Annual Driver’s Certificate of Violations
Driver’s Name ___________________________________________________________
Please Print
I certify that the following is true and complete list of traffic violations (other than parking violations) for which I have been convicted or forfeited bond or collateral during the past 12 months.
Date of Conviction Offence Location Type of vehicle
Operated
__________________ _________________ ______________ ________________
__________________ _________________ ______________ ________________
__________________ _________________ ______________ ________________
__________________ _________________ ______________ ________________
__________________ _________________ ______________ ________________
__________________ _________________ ______________ ________________
__________________ _________________ ______________ ________________
__________________ _________________ ______________ ________________
__________________ _________________ ______________ ________________
__________________ _________________ ______________ ________________
__________________ _________________ ______________ ________________
__________________ _________________ ______________ ________________
If no violations are listed above. I certify that I have not been convicted or forfeited bond or collateral on account of any violation required to be listed during the past 12 months.
______________________________ _______________________________________
Driver’s signature date
______________________________
_______________________________________
Motor carrier’s Name Motor Carrier’s
Address
______________________________
_______________________________________
Reviewed By: signature
Title
Annual Review of Driving Record
All the information pertaining to the above driver have been reviewed, including the driver’s accident record and violations of laws governing the operation of motor vehicles. The driver has been found to meet the minimum safe driving requirements and is not disqualified to drive a motor vehicle (391.25)
Comments
_______________________________________________________________
________________________________ __________________
___________________
Reviewed by Signature title
date