Back to Perkins Recruiting Page

Electronic On-Line Application

Thank you for your interest in Perkins Specialized Transportation's
owner operator program.

Please fill out the form below and click on the Submit Application button.  A representative from our fleet development department will contact you as soon as possible.  * - Denotes a required field.


(Hint: Use TAB to move from box to box. Using ENTER will immediately submit the form.)

Personal Information
*First Name:  

 *Middle Initial:

    
*Last Name:    
*Address:  
*City:  
*State:

 *Zip:
           
*Home Phone:

 

 Fax:    
Cell Phone:   E-Mail:
*SSN:   *Birthdate:
   mm/dd/yyyy
           
*CDL #:

*State:

 

*Class:

  
           
Are you at least 23 years old? Yes No
Moving violations in last 3 years:  
Accidents in last 3 years:  
Have you worked for Perkins before? Yes No   If yes, when?  
Are you a US citizen? Yes No
Can you legally live and work in the US? Yes No
Have you ever refused or tested positive
for a drug and/or alcohol test? 		Yes No
Have you had a DUI within the last 7 years? Yes No
Have you ever been convicted of a felony? Yes No
If yes, what/when?

Are you able to pass a DOT physical
and drug test?		 Yes No
Do you require a DOT medical
waiver of any kind?		 Yes No
If yes, what?

*Are you a current owner/operator? Yes  No
If yes,

 
(Year)


(Make)


(Model)
Employment History

Most Recent Employer

Company Name:
Address:
City:
State:

 Zip:

  
Phone:  
Position Held:
Dates Employed - From:  
   mm/dd/yyyy

 To:

  
   mm/dd/yyyy
Reason for leaving:
Are you currently employed there?

Yes

 No
May we contact your current employer?

Yes

 No

Next Most Recent Employer

Company Name:
Address:
City:
State:

 Zip:
Phone:  
Position Held:
Dates Employed - From:  
   mm/dd/yyyy

 To:

  
   mm/dd/yyyy
Reason for leaving:

Next Most Recent Employer

Company Name:
Address:
City:
State:

 Zip:

  
Phone:  
Position Held:
Dates Employed - From:  
   mm/dd/yyyy

 To:

  
   mm/dd/yyyy
Reason for leaving:
     
Do you use a PC/laptop for business purposes? Yes No
Will you have use of a cell phone during the time you are contracted with Perkins? Yes No
How did you find out about Perkins?

Web Site   ITJ   Trucking 2000
Referred by:
Other:

   

In compliance with applicable Federal and State laws, qualified applicants are considered for all positions without regard to race, color, religious preference, sex, national origin, marital status, or non job-related disability.

By pressing the Submit Application button below:

  • I certify that this application, which was completed by me, and all entries and information on it are true and complete to the best of my knowledge.

  • I understand that failure to pass the DOT Drug test required at time of orientation will result in immediate dismissal.  All costs incurred for lodging and/or return travel will be at my own expense.

  • I hereby authorize Perkins Specialized Transportation, Inc. to obtain all records of employment and/or application for employment, including assessments of my job performance, ability, and fitness to each and every company (or their authorized agents) which may request such information in connection with my application with said company.

  • I  authorize the release of all alcohol and controlled substance testing results (or refusals to test) pursuant to 382.413 of the Federal Motor Carriers Safety Regulations and release this company from any liability of any type as a result of providing the above mentioned information to the above mentioned person.