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Harrisburg: (717) 233-7927
Gettysburg: (717) 334-3009
Lebanon: (717) 272-4655
About / History
District of Columbia
Northern Mariana Islands
U.S. Virgin Islands
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
Which CSR locations applying for?
Will you work overtime if asked?
When will you be avilable to begin work?
Apart from absence for religious observance, are you available for full-time work?
If no, what hours can you work?
Have you ever been convicted of a felony or misdemeanor?
If yes, please explain
Are you legally eligible for employment in the United States?
In the past three years, have you tested positive for illegal drugs or alcohol?
If yes, do you have documented evidence of completing the DOT Return-to-Duty process?
In the past three years, have you refused to take a drug or alcohol test?
If yes, have you completed the DOT Return-to-Duty requirements?
Do you have any special training or skills?
(languages, machine operation, computer software, etc.)
High School, College, and Business/Trade/Technical
School Name & Location
Course of Study
Did you Graduate?
Degree or Diploma
Please give accurate, complete full-time and part-time employment record for the last 5 years. Start with your present or most recent employer.
Employer Name & Location
Name/Phone of Supervisor
Have you served in the U.S. Armed Forces?
If yes, in what Branch?
Describe any training received relevant to the position for which you are applying.
Driver Experience and Qualifications
Only those applying for Class “A” or “B” CDL should complete the following section.
Have you ever been denied a license, permit or privilege to operate a motor vehicle?
Has any license, permit or privilege ever been suspended or revoked?
Type of Equipment
Dates (From – To)
Approx. Number of Total Miles
Straight Truck / Tractor and Semi-Trailer / Tractor – Two Trailers / Other
List States operated in for last five years
Special courses or training that will help you as a driver
Which safe driving awards do you hold and from whom?
Accident Record for Past 3 Years
Nature of Accident
Traffic Convictions and Forfeitures for the Past 3 Years
Please read before signing:
This certifies that I completed this application, and that all entries on it and information in it are true and complete to the best of my knowledge. I authorize investigation of all statements contained in this application and release any and all persons, companies or agencies responding to such investigations from any liability for releasing information. I understand that the Company may request information on my driving record from state and DOT agencies and I hereby authorize such investigations. I understand that I may be required to register with the Federal Motor Carrier Safety Administration (FMCSA) Drug & Alcohol Clearinghouse to authorize Consolidated Scrap to conduct a full query. I also understand that the misrepresentation or omission of facts called for in this application is cause for rejection of this application and/or subsequent dismissal from employment.
I further understand and agree that I may be required to take a post-offer/pre-employment physical or mental examination. I understand that I may be required to submit a substance abuse test as a condition of hiring or continued employment. I hereby agree to take such tests at such time and place designated by the Company and release the Company, its officer, directors, agents or employees from any and all claims arising in connection with the conduct of said tests or the use of the information obtained therefrom. I understand that I may be asked as part of the post-offer/pre-employment physical process about whether I use tobacco or nicotine products and/or be subject to testing for nicotine in my system. I further understand that if I am hired by CSR and qualify for health benefits under the CSR plan, my health insurance premium cost may by affected because I use tobacco and/or nicotine products.
I understand and agree that this waiver form remains valid during my tenure as an employee and may be used at any time by Consolidated Scrap for the purpose of obtaining updated information. A copy of this form will be as valid as the original.
I further understand that this application does not constitute a contract for or an offer of employment but is merely one step in the employment process.
I hereby acknowledge that I have read the above statements and understand them completely.
This field is for validation purposes and should be left unchanged.
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