Sales Driver

CDL Driver Pre Application

Personal Information Name: Keith A Kuder Jr SSN/SIN: 558 81 1047 DOB: 7/30/19Address: 564 N 800 W City: Orem State/Province: UT Zip/Postal Code: 84057 Phone: 801-***-**** Cell Phone: 801-***-**** *******@**********.***

Position Applying for: Student Applicant or No tractor trailer Experience Truck Driving School: TODD'S CDL Service, Inc. City/State: Spanish Fork, UT Graduation Date: 07/08/2011

License Information License Number: 174816505 State Issued: UT Class: Class A

Legal Questions

Are you currently authorized to work in the United States? YES

Have you ever been convicted of, or are charges currently pending for any of the following:

7/25/2011 9:37

1 of 3

Driver Pre-Application

Misdemeanor: YES Explain: Criminal Mischief, NCIC Code 2999 Feb. 14, 2007. Breaking an Ipod.

Driving a vehicle while under the influence of alcohol (.04 or more) or controlled substance: NO

Careless or reckless driving: NO

Denial, revocation or suspension of license, permit or privilege to operate a motor vehicle? NO

Possession, sale or use of a controlled substance including marijuana: NO

Have you ever tested positive or refused to test on any pre employment drug or alcohol test given by an employer or contracting company to which you applied for, but did not obtain?

NO

Have you ever been told you tested positive for drugs or alcohol? NO

Accident History

How many accidents and/or incidents have you had in the last 3 years? 0 Explain:

How many moving violations (TICKETS) have you had in the last 3 years? 0

Work History

Current / Previous Employer 1 Company Name: NLE City: Orem State/Province: UT

2 of 3

7/25/2011 9:37 AM

Driver Pre-Application

Phone: 801-***-**** Position/Title: Sales Rep. Are you currently employed here?

NO Start Date: 11/2007 End Date: 6/2010 Reason for Leaving: Laid Off.

Was this a tractor trailer driving position? NO

Previous Employer 2 Company Name: Convergys City: Orem State/Province: UT Phone: 801-***-**** Position/Title: Business End User Care Start Date: 2/2006 End Date: 11/2007 Reason for Leaving: Better Pay.

Was this a tractor trailer driving position? NO

3 of 3

7/25/2011 9:37

Contact this candidate