Matt Stookey Trucking | Trucking JobsEmployment Application Form - Matt Stookey Trucking

Employment Application Form

Fill out the form below to submit your application for employment. If you have any questions please call us at (319) 624-2040.

Note: You must be 21 or older and have a Class A CDL for your application to be accepted. Thank you!

Step 1 of 9

First Name*
Middle Name*
Last Name*
Preferred First Name*
Former Name*
Mother's Maiden Name*
Today's Date*
MM slash DD slash YYYY
State Your Age*
Please enter a number from 1 to 130.
Are you 21 or older?*
Only those 21 or older are allowed to apply.

Emergency Contact Information
Emergency Contact Name*
First Last
Relationship to you*
Their Phone Number*
Address*
Street Address City State / Province / Region ZIP / Postal Code Country
List all addresses where you have lived in the last three (3) years. Start with your present address.
How many addresses have you lived at in the last three (3) years?*
Please enter a number from 1 to 8.
Address 1*
Street Address City State / Province / Region ZIP / Postal Code Country
Date from*
MM slash DD slash YYYY
Date to*
MM slash DD slash YYYY
Address 2*
Street Address City State / Province / Region ZIP / Postal Code Country
Date from*
MM slash DD slash YYYY
Date to*
MM slash DD slash YYYY
Address 3*
Street Address City State / Province / Region ZIP / Postal Code Country
Date from*
MM slash DD slash YYYY
Date to*
MM slash DD slash YYYY
Address 4*
Street Address City State / Province / Region ZIP / Postal Code Country
Date from*
MM slash DD slash YYYY
Date to*
MM slash DD slash YYYY
Address 5*
Street Address City State / Province / Region ZIP / Postal Code Country
Date from*
MM slash DD slash YYYY
Date to*
MM slash DD slash YYYY
Address 6*
Street Address City State / Province / Region ZIP / Postal Code Country
Date from*
MM slash DD slash YYYY
Date to*
MM slash DD slash YYYY
Address 7*
Street Address City State / Province / Region ZIP / Postal Code Country
Date from*
MM slash DD slash YYYY
Date to*
MM slash DD slash YYYY
Address 8*
Street Address City State / Province / Region ZIP / Postal Code Country
Date from*
MM slash DD slash YYYY
Date to*
MM slash DD slash YYYY

Driving Work History and Experience
How many driving jobs have you had total?*
Please enter a number from 1 to 15.
Job 1
Vehicle Class*
Fuel Type*
Number of Years Experience*
Please enter a number from 1 to 90.
Motor Carrier Name*
Date from*
MM slash DD slash YYYY
Date to*
MM slash DD slash YYYY
Employer Name*
Employer Address*
Street Address Address Line 2 City State ZIP Code
Position Held
Type of Business*
What industry was this business in?
Supervisor Name
Number of People Supervised
Rate of Pay
Current Employment Status*
Explain
Company Phone
Job 2
Vehicle Class*
Fuel Type*
Number of Years Experience*
Please enter a number from 1 to 90.
Motor Carrier Name*
Date from*
MM slash DD slash YYYY
Date to*
MM slash DD slash YYYY
Employer Name*
Employer Address
Street Address Address Line 2 City State ZIP Code
Position Held
Type of Business*
What industry was this business in?
Supervisor Name
Number of People Supervised
Rate of Pay
Current Employment Status*
Explain
Company Phone
Job 3
Vehicle Class*
Fuel Type*
Number of Years Experience*
Please enter a number from 1 to 90.
Motor Carrier Name*
Date from*
MM slash DD slash YYYY
Date to*
MM slash DD slash YYYY
Employer Name*
Employer Address
Street Address Address Line 2 City State ZIP Code
Position Held
Type of Business*
What industry was this business in?
Supervisor Name
Number of People Supervised
Rate of Pay
Current Employment Status*
Explain
Company Phone
Job 4
Vehicle Class*
Fuel Type*
Number of Years Experience*
Please enter a number from 1 to 90.
Motor Carrier Name*
Date from*
MM slash DD slash YYYY
Date to*
MM slash DD slash YYYY
Employer Name*
Employer Address
Street Address Address Line 2 City State ZIP Code
Position Held
Type of Business*
What industry was this business in?
Supervisor Name
Number of People Supervised
Rate of Pay
Current Employment Status*
Explain
Company Phone
Job 5
Vehicle Class*
Fuel Type*
Number of Years Experience*
Please enter a number from 1 to 90.
Motor Carrier Name*
Date from*
MM slash DD slash YYYY
Date to*
MM slash DD slash YYYY
Employer Name*
Employer Address
Street Address Address Line 2 City State ZIP Code
Position Held
Type of Business*
What industry was this business in?
Supervisor Name
Number of People Supervised
Rate of Pay
Current Employment Status*
Explain
Company Phone
Job 6
Vehicle Class*
Fuel Type*
Number of Years Experience*
Please enter a number from 1 to 90.
Motor Carrier Name*
Date from*
MM slash DD slash YYYY
Date to*
MM slash DD slash YYYY
Employer Name*
Employer Address
Street Address Address Line 2 City State ZIP Code
Position Held
Type of Business*
What industry was this business in?
Supervisor Name
Number of People Supervised
Rate of Pay
Current Employment Status*
Explain
Company Phone
Job 7
Vehicle Class*
Fuel Type*
Number of Years Experience*
Please enter a number from 1 to 90.
Motor Carrier Name*
Date from*
MM slash DD slash YYYY
Date to*
MM slash DD slash YYYY
Employer Name*
Employer Address
Street Address Address Line 2 City State ZIP Code
Position Held
Type of Business*
What industry was this business in?
Supervisor Name
Number of People Supervised
Rate of Pay
Current Employment Status*
Explain
Company Phone
Job 8
Vehicle Class*
Fuel Type*
Number of Years Experience*
Please enter a number from 1 to 90.
Motor Carrier Name*
Date from*
MM slash DD slash YYYY
Date to*
MM slash DD slash YYYY
Employer Name*
Employer Address
Street Address Address Line 2 City State ZIP Code
Position Held
Type of Business*
What industry was this business in?
Supervisor Name
Number of People Supervised
Rate of Pay
Current Employment Status*
Explain
Company Phone
Job 9
Vehicle Class*
Fuel Type*
Number of Years Experience*
Please enter a number from 1 to 90.
Motor Carrier Name*
Date from*
MM slash DD slash YYYY
Date to*
MM slash DD slash YYYY
Employer Name*
Employer Address
Street Address Address Line 2 City State ZIP Code
Position Held
Type of Business*
What industry was this business in?
Supervisor Name
Number of People Supervised
Rate of Pay
Current Employment Status*
Explain
Company Phone
Job 10
Vehicle Class*
Fuel Type*
Number of Years Experience*
Please enter a number from 1 to 90.
Motor Carrier Name*
Date from*
MM slash DD slash YYYY
Date to*
MM slash DD slash YYYY
Employer Name*
Employer Address
Street Address Address Line 2 City State ZIP Code
Position Held
Type of Business*
What industry was this business in?
Supervisor Name
Number of People Supervised
Rate of Pay
Current Employment Status*
Explain
Company Phone
Job 11
Vehicle Class*
Fuel Type*
Number of Years Experience*
Please enter a number from 1 to 90.
Motor Carrier Name*
Date from*
MM slash DD slash YYYY
Date to*
MM slash DD slash YYYY
Employer Name*
Employer Address
Street Address Address Line 2 City State ZIP Code
Position Held
Type of Business*
What industry was this business in?
Supervisor Name
Number of People Supervised
Rate of Pay
Current Employment Status*
Explain
Company Phone
Job 12
Vehicle Class*
Fuel Type*
Number of Years Experience*
Please enter a number from 1 to 90.
Motor Carrier Name*
Date from*
MM slash DD slash YYYY
Date to*
MM slash DD slash YYYY
Employer Name*
Employer Address
Street Address Address Line 2 City State ZIP Code
Position Held
Type of Business*
What industry was this business in?
Supervisor Name
Number of People Supervised
Rate of Pay
Current Employment Status*
Explain
Company Phone
Job 13
Vehicle Class*
Fuel Type*
Number of Years Experience*
Please enter a number from 1 to 90.
Motor Carrier Name*
Date from*
MM slash DD slash YYYY
Date to*
MM slash DD slash YYYY
Employer Name*
Employer Address
Street Address Address Line 2 City State ZIP Code
Position Held
Type of Business*
What industry was this business in?
Number of People Supervised
Rate of Pay
Current Employment Status*
Explain
Company Phone
Job 14
Vehicle Class*
Fuel Type*
Number of Years Experience*
Please enter a number from 1 to 90.
Motor Carrier Name*
Date from*
MM slash DD slash YYYY
Date to*
MM slash DD slash YYYY
Employer Name*
Employer Address
Street Address Address Line 2 City State ZIP Code
Position Held
Type of Business*
What industry was this business in?
Number of People Supervised
Rate of Pay
Current Employment Status*
Explain
Company Phone
Job 15
Vehicle Class*
Fuel Type*
Number of Years Experience*
Please enter a number from 1 to 90.
Motor Carrier Name*
Date from*
MM slash DD slash YYYY
Date to*
MM slash DD slash YYYY
Employer Name*
Employer Address
Street Address Address Line 2 City State ZIP Code
Position Held
Type of Business*
What industry was this business in?
Number of People Supervised
Rate of Pay
Current Employment Status*
Explain
Company Phone

Non Driving Employment History
For the last 10 years.
How many non driving jobs have you had total?*
Please enter a number from 0 to 10.
For the past 10 years.
Job 1
Date from*
MM slash DD slash YYYY
Date to*
MM slash DD slash YYYY
Employer Name*
Employer Address
Street Address Address Line 2 City State ZIP Code
Position Held
Type of Business*
What industry was this business in?
Supervisor Name
Number of People Supervised
Rate of Pay
Current Employment Status*
Explain
Company Phone
Job 2
Date from*
MM slash DD slash YYYY
Date to*
MM slash DD slash YYYY
Employer Name*
Employer Address*
Street Address Address Line 2 City State ZIP Code
Position Held
Type of Business*
What industry was this business in?
Supervisor Name
Number of People Supervised
Rate of Pay
Current Employment Status*
Explain
Company Phone
Job 3
Date from*
MM slash DD slash YYYY
Date to*
MM slash DD slash YYYY
Employer Name*
Employer Address*
Street Address Address Line 2 City State ZIP Code
Position Held
Type of Business*
What industry was this business in?
Supervisor Name
Number of People Supervised
Rate of Pay
Current Employment Status*
Explain
Company Phone
Job 4
Date from*
MM slash DD slash YYYY
Date to*
MM slash DD slash YYYY
Employer Name*
Employer Address*
Street Address Address Line 2 City State ZIP Code
Position Held
Type of Business*
What industry was this business in?
Supervisor Name
Number of People Supervised
Rate of Pay
Current Employment Status*
Explain
Company Phone
Job 5
Date from*
MM slash DD slash YYYY
Date to*
MM slash DD slash YYYY
Employer Name*
Employer Address*
Street Address Address Line 2 City State ZIP Code
Position Held
Type of Business*
What industry was this business in?
Supervisor Name
Number of People Supervised
Rate of Pay
Current Employment Status*
Explain
Company Phone
Job 6
Date from*
MM slash DD slash YYYY
Date to*
MM slash DD slash YYYY
Employer Name*
Employer Address*
Street Address Address Line 2 City State ZIP Code
Position Held
Type of Business*
What industry was this business in?
Supervisor Name
Number of People Supervised
Rate of Pay
Current Employment Status*
Explain
Company Phone
Job 7
Date from*
MM slash DD slash YYYY
Date to*
MM slash DD slash YYYY
Employer Name*
Employer Address*
Street Address Address Line 2 City State ZIP Code
Position Held
Type of Business*
What industry was this business in?
Supervisor Name
Number of People Supervised
Rate of Pay
Current Employment Status*
Explain
Company Phone
Job 8
Date from*
MM slash DD slash YYYY
Date to*
MM slash DD slash YYYY
Employer Name*
Employer Address*
Street Address Address Line 2 City State ZIP Code
Position Held
Type of Business*
What industry was this business in?
Supervisor Name
Number of People Supervised
Rate of Pay
Current Employment Status*
Explain
Company Phone
Job 9
Date from*
MM slash DD slash YYYY
Date to*
MM slash DD slash YYYY
Employer Name*
Employer Address*
Street Address Address Line 2 City State ZIP Code
Position Held
Type of Business*
What industry was this business in?
Supervisor Name
Number of People Supervised
Rate of Pay
Current Employment Status*
Explain
Company Phone
Job 10
Date from*
MM slash DD slash YYYY
Date to*
MM slash DD slash YYYY
Employer Name*
Employer Address*
Street Address Address Line 2 City State ZIP Code
Position Held
Type of Business*
What industry was this business in?
Supervisor Name
Number of People Supervised
Rate of Pay
Current Employment Status*
Explain
Company Phone

Personal & Commercial motor vehicle operator's licenses or permits
List all personal & commercial motor vehicle operator's licenses or permits issued in the past 3 years.
How many permits and licenses have you been issued*
Please enter a number from 0 to 3.
In the past 3 years.
License/Permit 1
License Number*
State/Province
Date issued*
MM slash DD slash YYYY
Date expired*
MM slash DD slash YYYY
License Type*
You must have a Class A CDL for your application to be accepted.
Current License
License/Permit 2
License Number*
State/Province
Date issued*
MM slash DD slash YYYY
Date expired*
MM slash DD slash YYYY
License Type*
You must have a Class A CDL for your application to be accepted.
Current License
License/Permit 3
License Number*
State/Province
Date issued*
MM slash DD slash YYYY
Date expired*
MM slash DD slash YYYY
License Type*
You must have a Class A CDL for your application to be accepted.
Current License

Have you ever had either your personal or commercial motor vehicle operator's license, permit, or privilege denied, revoked, or suspended?
Denied
Revoked
Suspended
Type of License*
License Number
Date
MM slash DD slash YYYY
For how long?
Comments
Education
How many types of schooling have you completed?*
Please enter a number from 1 to 4.
Including high school, technical college, or college degrees earned.
School 1
Type of School*
City
State
Number of years attended
Start Month
Finish Month
Graduated
Major
Degree Type*
School 2
Type of School*
City
State
Number of years attended
Start Month
Finish Month
Graduated
Major
Degree Type*
School 3
Type of School*
City
State
Number of years attended
Start Month
Finish Month
Graduated
Major
Degree Type*
School 4
Type of School*
City
State
Number of years attended
Start Month
Finish Month
Graduated
Major
Degree Type*

Healthcare
Date of last DOT physical
MM slash DD slash YYYY
Healthcare Professional's Name*
First Last
Address*
Street Address City State / Province / Region ZIP / Postal Code Country
FedEx Contacts
Do you know anyone employed or contracted by FedEx Ground/FedEx Home Delivery?
Name
First Last
Position
Location
Relationship
Are you related to anyone employed or contracted by FedEx Ground/FedEx Home Delivery?
Name
First Last
Position
Location
Relationship
Military Service
Date served from
MM slash DD slash YYYY
Date served to
MM slash DD slash YYYY
Branch
Primary Specialty
Rank at Discharge
Type of Discharge
Certification
This certifies that this request was completed by me, and that all entries on it and information in it are true and complete to the best of my knowledge. I understand that false or misleading information may result in FedEx Ground/FedEx Home Delivery disqualifying me or any contract with has been executed. I authorize Fed Ex Ground/FedEx Home Delivery to make whatever motor vehicle record investigation it deems necessary.
Fair Credit Reporting Act Disclosure Statement
You, in connection with this service, authorize all corporations, companies, credit agencies, educational institutions, law enforcement agencies, military services, former employers and individuals to release information they may have about me to FedEx Ground and their agents, and release them from any liability or responsibility for doing so. I further authorize the procurement of an investigative consumer report and understand that such a report may contain information about my background, character and personal reputation and that further information may be available upon written request within a resonable period of time.
Employer Verification Disclosure Statement
You authorize FedEx ground and/or a third party to verify my employment. This authorization is to remain in full force and in effect until I notify FedEx Ground to terminate the authorization.

You affirmatively consent to the use of this electronic form ("E-FORM") and acknowledge your right, or option, to complete this information sheet in a non-electronic form. Your consent to use this electronic information sheet may be subsequently withdrawn through written notice to FedEx Ground. Your execution of this information sheet, by electronic signature, affirms the foregoing information is true and correct to the best of your knowledge.
Pursuant to the provisions of paragraph(8) (10) of section 391.21 of the Federal Motor Carrier Safety Regulations you are herin notified that if you are to be considered for contracting or driving by FedEx Ground. The information which y ou have provided in accordance with this paragraph may be used, and your prior employers may be contacted, for the purposes of investigating your background as required by section 391.23.*
First Last
Today's Date*
MM slash DD slash YYYY
This document has been signed electronically by the above named person on this date and the electronic signature shall for all purposes be considered equal to manual signature, as set forth in the Electronic Signatures in Global and National Commerce Act, the Uniform Electronic Transactions Act, and applicable state statues.
Name
This field is for validation purposes and should be left unchanged.

Honest, Dependable Employment

Employment Application Form

Step 1 of 9

Emergency Contact Information

List all addresses where you have lived in the last three (3) years. Start with your present address.

Driving Work History and Experience

Job 1

Job 2

Job 3

Job 4

Job 5

Job 6

Job 7

Job 8

Job 9

Job 10

Job 11

Job 12

Job 13

Job 14

Job 15

Non Driving Employment History

Job 1

Job 2

Job 3

Job 4

Job 5

Job 6

Job 7

Job 8

Job 9

Job 10

Personal & Commercial motor vehicle operator's licenses or permits

License/Permit 1

License/Permit 2

License/Permit 3

Have you ever had either your personal or commercial motor vehicle operator's license, permit, or privilege denied, revoked, or suspended?

Education

School 1

School 2

School 3

School 4

Motor Vehicle Accidents

Healthcare

FedEx Contacts

Military Service

Certification

Fair Credit Reporting Act Disclosure Statement

Employer Verification Disclosure Statement