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TCT Online Application

Today's Date(Required)

MM slash DD slash YYYY

Position (s) Applied Form(Required)

Last Name(Required)

First Name(Required)

Middle Name(Required)

Maiden/Former Name(Required)

Address(Required)

Street Address City State / Province / Region ZIP / Postal Code

Telephone(Required)

Date of Birth(Required)

MM slash DD slash YYYY

Social Security Number(Required)

Previous Address - List addresses for the last three years(Required)

Address

City

State

Zip Code

Past Employment DO NOT LEAVE ANY BLANKS

Fill out this section in its entirety. List your current or most recent employer first. Account for employment experience for the past 10 years, including military service.

Previous Employer

Company Name(Required)

Address(Required)

Street Address City State / Province / Region ZIP / Postal Code

Telephone(Required)

Position Held(Required)

Immediate Supervisor's Name and Contact Number(Required)

Start Date(Required)

MM slash DD slash YYYY

End Date(Required)

MM slash DD slash YYYY

Start Rate(Required)

End Rate(Required)

Description of Duties(Required)

Reason for Leaving(Required)

Was your Position Subject to the FMCSR's?(Required)

Was your Position Subject to DOT Alcohol & Controlled Substance Testing?(Required)

May we Contact this Employer?(Required)

Yes

No

Previous Employer

Fill out this section in its entirety , even if similar information is included in your resume. List your most recent employer first. Account for employment experience for past 10 years , including military service. Please attach separate sheet to application.

Company Name(Required)

Address(Required)

Street Address City State / Province / Region ZIP / Postal Code

Telephone(Required)

Position Held(Required)

Immediate Supervisor's Name and Contact Number(Required)

Start Date(Required)

MM slash DD slash YYYY

End Date(Required)

MM slash DD slash YYYY

Start Rate(Required)

End Rate(Required)

Description of Duties(Required)

Reason for Leaving(Required)

Was your Position Subject to the FMCSR's?(Required)

Was your Position Subject to DOT Alcohol & Controlled Substance Testing?(Required)

May we Contact this Employer?(Required)

Yes

No

Previous Employer

Company Name(Required)

Address(Required)

Street Address City State / Province / Region ZIP / Postal Code

Telephone(Required)

Position Held(Required)

Immediate Supervisor's Name and Contact Number(Required)

Start Date(Required)

MM slash DD slash YYYY

End Date(Required)

MM slash DD slash YYYY

Start Rate(Required)

End Rate(Required)

Description of Duties(Required)

Reason for Leaving(Required)

Was your Position Subject to the FMCSR's?(Required)

Was your Position Subject to DOT Alcohol & Controlled Substance Testing?(Required)

May we Contact this Employer?(Required)

Yes

No

Previous Employer

Company Name(Required)

Address(Required)

Street Address City State / Province / Region ZIP / Postal Code

Telephone(Required)

Position Held(Required)

Immediate Supervisor's Name and Contact Number(Required)

Start Date(Required)

MM slash DD slash YYYY

End Date(Required)

MM slash DD slash YYYY

Start Rate(Required)

End Rate(Required)

Description of Duties(Required)

Reason for Leaving(Required)

Was your Position Subject to the FMCSR's?(Required)

Was your Position Subject to DOT Alcohol & Controlled Substance Testing?(Required)

May we Contact this Employer?(Required)

Yes

No

Previous Employer

Company Name(Required)

Address(Required)

Street Address City State / Province / Region ZIP / Postal Code

Telephone(Required)

Position Held(Required)

Immediate Supervisor's Name and Contact Number(Required)

Start Date(Required)

MM slash DD slash YYYY

End Date(Required)

MM slash DD slash YYYY

Start Rate(Required)

End Rate(Required)

Description of Duties(Required)

Reason for Leaving(Required)

Was your Position Subject to the FMCSR's?(Required)

Was your Position Subject to DOT Alcohol & Controlled Substance Testing?(Required)

May we Contact this Employer?(Required)

Yes

No

Previous Employer

Company Name(Required)

Address(Required)

Street Address City State / Province / Region ZIP / Postal Code

Telephone(Required)

Position Held(Required)

Immediate Supervisor's Name and Contact Number(Required)

Start Date(Required)

MM slash DD slash YYYY

End Date(Required)

MM slash DD slash YYYY

Start Rate(Required)

End Rate(Required)

Description of Duties(Required)

Reason for Leaving(Required)

Was your Position Subject to the FMCSR's?(Required)

Was your Position Subject to DOT Alcohol & Controlled Substance Testing?(Required)

May we Contact this Employer?(Required)

Yes

No

Previous Employer

Company Name(Required)

Address(Required)

Street Address City State / Province / Region ZIP / Postal Code

Telephone(Required)

Position Held(Required)

Immediate Supervisor's Name and Contact Number(Required)

Start Date(Required)

MM slash DD slash YYYY

End Date(Required)

MM slash DD slash YYYY

Start Rate(Required)

End Rate(Required)

Description of Duties(Required)

Reason for Leaving(Required)

Was your Position Subject to the FMCSR's?(Required)

Was your Position Subject to DOT Alcohol & Controlled Substance Testing?(Required)

May we Contact this Employer?(Required)

Yes

No

Previous Employer

Company Name(Required)

Address(Required)

Street Address City State / Province / Region ZIP / Postal Code

Telephone(Required)

Position Held(Required)

Immediate Supervisor's Name and Contact Number(Required)

Start Date(Required)

MM slash DD slash YYYY

End Date(Required)

MM slash DD slash YYYY

Start Rate(Required)

End Rate(Required)

Description of Duties(Required)

Reason for Leaving(Required)

Was your Position Subject to the FMCSR's?(Required)

Was your Position Subject to DOT Alcohol & Controlled Substance Testing?(Required)

May we Contact this Employer?(Required)

Yes

No

Previous Employer

Company Name(Required)

Address(Required)

Street Address City State / Province / Region ZIP / Postal Code

Telephone(Required)

Position Held(Required)

Immediate Supervisor's Name and Contact Number(Required)

Start Date(Required)

MM slash DD slash YYYY

End Date(Required)

MM slash DD slash YYYY

Start Rate(Required)

End Rate(Required)

Description of Duties(Required)

Reason for Leaving(Required)

Was your Position Subject to the FMCSR's?(Required)

Was your Position Subject to DOT Alcohol & Controlled Substance Testing?(Required)

May we Contact this Employer?(Required)

Yes

No

Previous Employer

Company Name(Required)

Address(Required)

Street Address City State / Province / Region ZIP / Postal Code

Telephone(Required)

Position Held(Required)

Immediate Supervisor's Name and Contact Number(Required)

Start Date(Required)

MM slash DD slash YYYY

End Date(Required)

MM slash DD slash YYYY

Start Rate(Required)

End Rate(Required)

Description of Duties(Required)

Reason for Leaving(Required)

Was your Position Subject to the FMCSR's?(Required)

Was your Position Subject to DOT Alcohol & Controlled Substance Testing?(Required)

May we Contact this Employer?(Required)

Yes

No

Previous Employer

Company Name(Required)

Address(Required)

Street Address City State / Province / Region ZIP / Postal Code

Telephone(Required)

Position Held(Required)

Immediate Supervisor's Name and Contact Number(Required)

Start Date(Required)

MM slash DD slash YYYY

End Date(Required)

MM slash DD slash YYYY

Start Rate(Required)

End Rate(Required)

Description of Duties(Required)

Reason for Leaving(Required)

Was your Position Subject to the FMCSR's?(Required)

Was your Position Subject to DOT Alcohol & Controlled Substance Testing?(Required)

May we Contact this Employer?(Required)

Yes

No

MVR Information

Answer All Questions-Leave No Blank

Driving Experience

Valid driver’s license number and issuing state(Required)

TX(Required)

Class(Required)

Expires(Required)

List states operated in for the last three years(Required)

Has your license ever been revoked/suspended?(Required)

Yes

No

DOB(Required)

MM slash DD slash YYYY

If yes, please explain:(Required)

Class of Equipment

Type of Equipment (Van, Tank, Flat, Etc.) Leave No Blanks

Straight Truck(Required)

Tractor & Semi-Trailer(Required)

Tractor-Two Trailers(Required)

Motor Coach-School Bus(Required)

Other

Dates From To Leave No Blanks

Tractor & Semi-Trailer(Required)

Straight Truck(Required)

Motor Coach-School Bus(Required)

Tractor-Two Trailers(Required)

Other

Approximate Number of Total Miles Leave No Blanks

Tractor & Semi-Trailer(Required)

Straight Truck(Required)

Motor Coach-School Bus(Required)

Tractor-Two Trailers(Required)

Other

Restrictions(Required)

(If no driver’s license, please check None)

None

Endorsements(Required)

List All Accidents for the past 3 years, including the above reported vehicle accidents. Write “NONE” if none to report.(Required)

Date

Location

Describe

List All Traffic Citations for the past 3 years, including the above reported vehicle accidents. Write “NONE” if none to report(Required)

Date

Location

Describe

List All Alcohol/Drug Related Driving Offenses (DWI, DUI, Etc.) Write “NONE” if none to report.(Required)

Date

Location

Describe

CRIMINAL HISTORY: Have you ever been convicted, plead guilty, or accepted deferred adjudication as a result of any misdemeanor or felony criminal charge filed against you in state, federal or military court?(Required)

Yes

No

I CERTIFY THIS APPLICATION WAS COMPLETED BY ME, AND ALL ENTRIES ON IT AND INFORMATION IN IT ARE TRUE AND COMPLETE TO THE BEST OF MY KNOWLEDGE.

Applicant Print Name(Required)

Signature(Required)

Date Signed(Required)

MM slash DD slash YYYY

CAPTCHA

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Open it using a PDF reader program (Foxit Reader or Adobe Acrobat Reader DC).
Fill out and Submit.

Apply for:

Country

State

City

Postal Code

Upload your driver license

Location

Texas Chrome Transport, Inc.
16233 IH 35 South
Atascosa, Texas 78002

Phone

t. + Local: (210) 669-6161
f. + Fax: (210) 622-5750

Email

Onboarding@TeamTCT.com

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