Cardinal Transport Pre-Application

First Name:

Middle Name:
Last Name:
Address
City, State, Zip
Phone No.
Date of Birth
Soc. Sec. No.
Alternate means of contact
E-mail address
CDL No., State
Years of experience**
# of tickets last 3 years
# of accidents last 3 years
Tractor Make & Year

**Flatbed, Step Deck, RGN, Double Drop Only    We are not currently accepting van trailer experience

Do you have 18 months verifiable flatbed experience ?:       

Do you agree to allow us to check your MVR ?:       

Do you have your own D.O.T. authority?:      

All fields must be filled before this application will be processed

           IMPORTANT NOTICE

REGARDING BACKGROUND REPORTS

        FROM THE PSP Online Service

 

 In connection with your application for qualification as an “Independent Contractor or Lessee” with Cardinal Transport, Inc. (“Prospective Contracting Carrier or Lessor ”), it may obtain one or more reports regarding your driving, and safety inspection history from the Federal Motor Carrier Safety Administration (FMCSA). If Cardinal Transport, Inc. uses any information it obtains from FMCSA in its decision to not qualify you or to make any other adverse qualification decision regarding you, Cardinal Transport, Inc. (“Prospective Contracting Carrier) will provide you with a copy of the report upon which its decision was based and a written summary of your rights under the Fair Credit Reporting Act before taking any final adverse action. If any final adverse action is taken against you based upon your driving history or safety report, Cardinal Transport, Inc. (“Prospective Contracting Carrier”) will notify you that the action has been taken and that the action was based in part or in whole on this report. Cardinal Transport, Inc., (“Prospective Contracting Carrier”) cannot obtain background reports from FMCSA unless you consent in writing. If you agree that Cardinal Transport, Inc. may obtain such background reports, please read the following and sign below.

 I authorize Cardinal Transport, Inc. (“Prospective Contracting Carrier/Lessor”) to access the FMCSA Pre-Employment Screening Program (PSP) system to seek information regarding my commercial driving safety record and information regarding my safety inspection history.  

 I understand that I am consenting to the release of safety performance information including crash data from the previous five (5) years and inspection history from the previous three (3) years. 

 I understand and acknowledge that this release of information may assist Cardinal Transport, Inc. to make a determination regarding my suitability as an Independent Contractor/Lessee. 

 I further understand that neither the Prospective Contracting Carrier nor the FMCSA contractor supplying the crash and safety information has the capability to correct any safety data that appears to be incorrect. 

 I understand I may challenge the accuracy of the data by submitting a request to https://dataqs.fmcsa.dot.gov/.   If I am challenging crash or inspection information reported by a State, FMCSA cannot change or correct this data. I understand my request will be forwarded by the DataQs system to the appropriate State for adjudication. 

 In addition to the above, I understand that I will be required to sign this release in a complete paper format with my complete application at time of submission.

Yes, I understand terms and conditions.

            

By submitting this form I understand and agree to all conditions stated on this application.

Following submission of the safety summary, please contact Cardinal's recruiting department
at 800-435-9302 to expedite the processing of this document and to answer any additional
questions that may arise.

This Pre-application may also be printed out and faxed to our recruiting department at 815-634-3254.

    Our full application can be found here  If directed, please print and then fill out completely.