Hidden - Set on Load - Set Specific for This Web Version: WebDriverApplication05/17/2012 Hidden - Set on Load - Set Same for Prospect Forms: IDCW-8UE5PL Hidden - Set on Load - Computed for Display for All Web Forms: (optional)(#)(month)(day)(year)(mm/dd/yyyy)(mm/yyyy)(mm/yy)(xxx-xxx-xxxx)(account@domain.com)(http://www.domain.com)(xxx-xx-xxxx)(in last 3 years)Yes; NoAlabama|AL; Alaska|AK; Arizona|AZ; Arkansas|AR; California|CA; Colorado|CO; Connecticut|CT; Delaware|DE; District of Columbia|DC; Florida|FL; Georgia|GA; Hawaii|HI; Idaho|ID; Illinois|IL; Indiana|IN; Iowa|IA; Kansas|KS; Kentucky|KY; Louisiana|LA; Maine|ME; Maryland|MD; Massachusetts|MA; Michigan|MI; Minnesota|MN; Mississippi|MS; Missouri|MO; Montana|MT; Nebraska|NE; Nevada|NV; New Hampshire|NH; New Jersey|NJ; New Mexico|NM; New York|NY; North Carolina|NC; North Dakota|ND; Ohio|OH; Oklahoma|OK; Oregon|OR; Pennsylvania|PA; Rhode Island|RI; South Carolina|SC; South Dakota|SD; Tennessee|TN; Texas|TX; Utah|UT; Vermont|VT; Virginia|VA; Washington|WA; West Virginia|WV; Wisconsin|WI; Wyoming|WYAlabama; Alaska; Arizona; Arkansas; California; Colorado; Connecticut; Delaware; District of Columbia; Florida; Georgia; Hawaii; Idaho; Illinois; Indiana; Iowa; Kansas; Kentucky; Louisiana; Maine; Maryland; Massachusetts; Michigan; Minnesota; Mississippi; Missouri; Montana; Nebraska; Nevada; New Hampshire; New Jersey; New Mexico; New York; North Carolina; North Dakota; Ohio; Oklahoma; Oregon; Pennsylvania; Rhode Island; South Carolina; South Dakota; Tennessee; Texas; Utah; Vermont; Virginia; Washington; West Virginia; Wisconsin; WyomingAL; AK; AZ; AR; CA; CO; CT; DE; DC; FL; GA; HI; ID; IL; IN; IA; KS; KY; LA; ME; MD; MA; MI; MN; MS; MO; MT; NE; NV; NH; NJ; NM; NY; NC; ND; OH; OK; OR; PA; RI; SC; SD; TN; TX; UT; VT; VA; WA; WV; WI; WY01; 02; 03; 04; 05; 06; 07; 08; 09; 10; 11; 1201; 02; 03; 04; 05; 06; 07; 08; 09; 10; 11; 12; 13; 14; 15; 16; 17; 18; 19; 20; 21; 22; 23; 24; 25; 26; 27; 28; 29; 30; 311994, 1993, 1992, 1991, 1990, 1989, 1988, 1987, 1986, 1985, 1984, 1983, 1982, 1981, 1980, 1979, 1978, 1977, 1976, 1975, 1974, 1973, 1972, 1971, 1970, 1969, 1968, 1967, 1966, 1965, 1964, 1963, 1962, 1961, 1960, 1959, 1958, 1957, 1956, 1955, 1954, 1953, 1952, 1951, 1950, 1949, 1948, 1947, 1946, 1945, 19442012, 2013, 2014, 2015, 2016, 2017, 2018, 2019, 2020, 2021, 2022, 2023, 2024, 2025, 2026, 2027, 2028, 2029, 2030(years)(months)(inches)(pounds)2012, 2011, 2010, 2009, 2008, 2007, 2006, 2005, 2004, 2003, 2002, 2001, 2000, 1999, 1998, 1997, 1996, 1995, 1994, 1993, 1992, 1991, 1990, 1989, 1988, 1987, 1986, 1985, 1984, 1983, 1982, 1981, 1980, 1979, 1978, 1977, 1976, 1975, 1974, 1973, 1972, 1971, 1970, 1969, 1968, 1967, 1966, 19652012, 2011, 2010, 2009, 2008, 2007, 2006, 2005, 2004, 2003, 2002, 2001, 2000, 1999, 1998, 1997, 1996, 1995, 1994I accept and submit this application|Yes Hidden - Set on Load - Computed for Display for All Form Versions - Same Options as Client Keywords: Home Phone; Cell Phone; Mail; EmailCompany Solo; Owner Operator; Company TeamAll 48 States; Dedicated; Local; RegionalReefer; VanDouble/Triple Trailers; Hazardous Materials; NoneFlatbed; Straight Truck; Household Goods; Refrigerated; Tanker; VanDedicated; General Line; LocalGeneral LineCompany Driver; Fleet Owner; SoloAll 48 States; Northwest; Midwest; Intrastate; Southwest; Southeast; Local; West; EastFreightliner; International; Kenworth; Mack; Peterbilt; Sterling; Volvo45; 46; 47; 48220-230; 230-240; 240-250; 250-260; 265-27018500-19500; 19500-21000Air; Spring Hidden - Set on Load - Computed for Display for This Web Version Only - Different Options than Client Keywords: Recruiting Edge; Driver Jackpot; Great American Truck Show; Great West Truck Show; The Trucker; Company Driver/OO Magazine; Team Driver Magazine; Truckers Connection Magazine; Trucking 2010 Magazine; Changing Lanes Magazine; Best Driver Job Magazine; CSA 2010 Magazine; A Magazine; TruckJobSeekers.com; EveryTruckJob.com; JiggyJobs.com; BigTruckDrivingJobs.com; ClassADrivers.com; HiringTruckDrivers.com; CDLJobs.com; BestDriverJobs.com; Layover.com; Truckflix.com; LinkedIn.com; Twitter.com; Indeed.com; Monster.com; Facebook.com; Craigslist.org; Trailer Decal; Driver; Employee; Email Ad; Newspaper; Poster2012; 2011; 2010; 2009; 2008; 2007; 2006; 2005; 2004; 2003; 2002; 2001; 2000; 1999; 1998; 1997; 1996; 1995; 1994 Hidden - Set on Load - Computed for Display for This Web Version: User:&nbsp;<b>Anonymous</b>&nbsp;&nbsp;&nbsp;&nbsp;<span class="redirectlinks" onClick="redirectPage('mailto:web_info@intd.com')" onMouseOver="objectChangeClass(this, event, 'redirectlinks')" onMouseOut="objectChangeClass(this, event, 'redirectlinks')">Email WebAdmin</span>&nbsp;&nbsp;|&nbsp;&nbsp;<span class="redirectlinks" onClick="redirectPage('http://apps.intd.com/webelements.nsf/WebAppsHome')" onMouseOver="objectChangeClass(this, event, 'redirectlinks')" onMouseOut="objectChangeClass(this, event, 'redirectlinks')">Apps Home</span>&nbsp;&nbsp;|&nbsp;&nbsp;<span class="redirectlinks" onClick="redirectPage('http://www.intd.com')" onMouseOver="objectChangeClass(this, event, 'redirectlinks')" onMouseOut="objectChangeClass(this, event, 'redirectlinks')">IDC Home</span>http://www.intd.com/html/careers/career-opportunities.html Hidden - Set During Use - Hidden on This Web Version: Hidden - Set During Use - Visible on This Web Version: Hidden - Set on Save - Set Specific for This Web Version:
Hidden - Set During Use - Not Saved - MUST BE INSIDE BODY: Interstate Distributor Co. - Driver Application Personal Information17Personal Information
Interstate Distributor Co. - Driver Application
Interstate Distributor Co. - Driver Application
Personal Information
*= Required Field
User: Anonymous    Email WebAdmin  |  Apps Home  |  IDC Home
Personal Information
First Name:*       Middle: (optional)
      Middle:  		Last Name:*
Social Security #:* (xxx-xx-xxxx)
 Date of Birth:*
     (month)
      (day)
      (year)
Physical Address:*
City, State  Zip:*
 ,
      
Mailing Address: City, State  Zip:
 ,      
Home Phone: (xxx-xxx-xxxx)
 Cell / Other Phone: (xxx-xxx-xxxx)
Email Address: (account@domain.com)
 Best Way to Contact:
Referred By:      
Referring Driver:
Referring Employee:
Referring Recruiter:
Referring Poster:
Referring Newspaper:
Referring Magazine:
Position Applying For: Team Name:
Running Area: Running Fleet:
Number of Jobs:* (#)(in last 3 years)
(in last 3 years)
Licenses Held
CDL Class A License #:* (in last 3 years)
(in last 3 years)
 		CDL State of Issue:*      
CDL Expiration Date:
     (month)
      (day)
      (year)
Physical Expiration Date:
     (month)
      (day)
      (year)
Other License #: (in last 3 years)
(in last 3 years)
 		State of Issue:      
Other License #: (in last 3 years)
(in last 3 years)
 		State of Issue:      
Endorsements:
Driving Experience
General Experience
Driving Experience:*
(#)(years)
 (#)(months)
(years)
  (months)
 		Trailer Experience:

Months OTR Driving: Months Local Driving:
Owner-Operator Experience / Equipment
Tractor Make:       Truck Year:      
Fifth Wheel Height:      (inches)
(inches)
 		Wheel Base:      (inches)
(inches)
Bobtail Weight:      (pounds)
(pounds)
 		Suspension Type:      
Safety Overview
Number of Accidents: (#)(in last 3 years)
(in last 3 years)
 		Date / Details:
Number of Tickets: (#)(in last 3 years)
(in last 3 years)
 		Date / Details:
DWI / DUI Conviction? Date / Details:
Felony Conviction? Date / Details:
License Revoked or Suspended? Date / Details:
Tested Positive to a Controlled Substance? Date / Details:
Employment / Leasing History
Present or Last Employer
Company Name:*
Permission to Contact?*
Employ / Lease From:*
     (month)
      (year)
Employ / Lease To:*
     (month)
      (year)
Position:*
Reason for Leaving:
Address: City, State:*
 ,
      
Office Phone: (xxx-xxx-xxxx)
 Reference Contact:
Equipment Pulled:

Driving Area:

Second to Last Employer
Company Name: Permission to Contact?
Employ / Lease From:
     (month)
      (year)
Employ / Lease To:
     (month)
      (year)
Position: Reason for Leaving:
Address: City, State:
 ,      
Office Phone: (xxx-xxx-xxxx)
 Reference Contact:
Equipment Pulled:

Driving Area:

Back to Top
Third to Last Employer
Company Name: Permission to Contact?
Employ / Lease From:
     (month)
      (year)
Employ / Lease To:
     (month)
      (year)
Position: Reason for Leaving:
Address: City, State:
 ,      
Office Phone: (xxx-xxx-xxxx)
 Reference Contact:
Equipment Pulled:

Driving Area:

Back to Top
Additional Employment Information
Back to Top
Personal Information
First Name:       Middle:  Last Name:
Social Security #: Date of Birth:
Physical Address: City, State  Zip:
Mailing Address: City, State  Zip:
Home Phone: Cell / Other Phone:
Email Address: Best Way to Contact:
Referred By:
Referring Driver:
Referring Employee:
Referring Recruiter:
Referring Poster:
Referring Newspaper:
Referring Magazine:
Position Applying For: Team Name:
Running Area: Running Fleet:
Number of Jobs:
(in last 3 years)
Licenses Held
CDL Class A License #:
(in last 3 years)
 CDL State of Issue:
CDL Expiration Date:
Physical Expiration Date:
Other License #:
(in last 3 years)
 State of Issue:
Other License #:
(in last 3 years)
 State of Issue:
Endorsements
Driving Experience
General Experience
Driving Experience:
(years)
  (months)
 Trailer Experience:
Months OTR Driving: Months Local Driving:
Owner-Operator Experience / Equipment
Tractor Make: Truck Year:
Fifth Wheel Height:
(inches)
 Wheel Base:
(inches)
Bobtail Weight:
(pounds)
 Suspension Type:
Safety Overview
Number of Accidents:
(in last 3 years)
 Date / Details:
Number of Tickets:
(in last 3 years)
 Date / Details:
DWI / DUI Conviction? Date / Details:
Felony Conviction? Date / Details:
License Revoked or Suspended? Date / Details:
Tested Positive to a Controlled Substance? Date / Details:
Employment / Leasing History
Present or Last Employer
Company Name: Permission to Contact?
Employ / Lease From: Employ / Lease To:
Position: Reason for Leaving:
Address: City, State:
Office Phone: Reference Contact:
Equipment Pulled: Driving Area:
Second to Last Employer
Company Name: Permission to Contact?
Employ / Lease From: Employ / Lease To:
Position: Reason for Leaving:
Address: City, State:
Office Phone: Reference Contact:
Equipment Pulled: Driving Area:
Third to Last Employer
Company Name: Permission to Contact?
Employ / Lease From: Employ / Lease To:
Position: Reason for Leaving:
Address: City, State:
Office Phone: Reference Contact:
Equipment Pulled: Driving Area:
Additional Employment Information
Back to Top
Electronic Application Release
  • By submitting this application electronically, I certify that I personally completed this application for employment (or lease) and that all of the information is true and correct.
Today's Date: 05/17/2012 Applicant Name: *
 I accept and submit this application: