Application-start | Behnke Dedicated & Logistics

About
Careers
Customer Solutions

Select Page

Behnke Logistics Job Application

Step 1 of 18

5%

Date of Application*
MM slash DD slash YYYY
Position Applied For:*
CDL Number:*
State of Issuance*
Your Name*
First Middle Last
Home Address*
Street Address Address Line 2 City State ZIP Code
SSN*
D.O.B*
MM slash DD slash YYYY
Home Phone
Cell Phone*
Your Email*
Enter Email Confirm Email
How did you find out about Behnke Logistics?*
- Craigslist
- Facebook
- Indeed

Save and Continue Later

Previous Residency
Please fill out your last two previous addresses. and answer the questions. below.
Previous Address #1*
Street Address City State ZIP Code
Previous Address #2
Street Address City State ZIP Code
Do you have the legal right to work in the United States?*
- Yes
- No
Have you ever been convicted of a felony?*
- Yes
- No
Are you over the age of 18?*
- Yes
- No
Can you provide proof of your age?*
- Yes
- No

Save and Continue Later

Emergency Contacts*
Name Phone Relationship
Education*
School City, State Years Completed Degree Course of Study
Skills:
List any job-related skills, qualifications, education or information that support your application.
In order to permit check of your work and educational records, should we be aware of any changes of name or assumed name that you previously used?*
- Yes
- No
Please Identify Names and Relevant Dates*
Name Date

Save and Continue Later

Have you worked for us before?*
- Yes
- No
*
From: To: Position Rate of Pay
Reason for leaving?*
Have you ever filed an application here before?*
- Yes
- No
When?*
MM slash DD slash YYYY
Are you currently employed?*
- Yes
- No
When was the last day of previous employment?*
MM slash DD slash YYYY
Who referred you?
Rate of pay expected?*
Have you ever been dismissed or forced to resign from employment?*
- Yes
- No
Why?*
May we contact your present employer?*
- Yes
- No
May we contact your previous employer(s)?*
- Yes
- No
Please identify any exceptions and reasons for not contacting prior employers:*
Are you a Veteran of the U.S. Military Services?*
- Yes
- No
What branch of service?*
Beginning Date:*
MM slash DD slash YYYY
End Date:*
MM slash DD slash YYYY
Date of Discharge:*
MM slash DD slash YYYY
Do you have transportation to and from work?*
- Yes
- No
Will you work overtime if asked?*
- Yes
- No
Are there any hours, shifts, or days you will not work?*
- Yes
- No
What days and why?*
Are you on layoff?*
- Yes
- No
Are you subject to recall?*
- Yes
- No
Is there any reason you might be unable to perform the functions of the job which you have applied for?*
- Yes
- No
Explain:*

Save and Continue Later

Personal References:*
Name Address Phone Number Occupation

List three persons not related to you whom you have known at least one year:

Save and Continue Later

Employment History
All driver applications to drive in interstate commerce must provide the following information on all employers during the preceding three (3) years. Applicants to drive a commercial motor vehicle* in intrastate or interstate commerce shall also provide an additional seven (7) years information on those employers for whom the applicant operated such vehicle. ( Note: List employers in reverse order starting with the most recent. )
Employer Name:*
From: (mm/yyyy)*
To: (mm/yyyy)*
Position Held:*
Salary/Wage*
Location Address:*
City State ZIP Code
Contact Person*
Phone Number:*
Reason For Leaving:*
Were you subject to the FMCSR while employed?*
- Yes
- No
Was your job designated as a safety sensitive function in any DOT regulated mode subject to the drug and alcohol testing requirements of 40CFR part 40?*
- Yes
- No
Previous Employer #2*
- Yes
- No
Previous Employer #2
Employer Name:
From (mm/yyyy):
To (mm/yyyy):
Position Held:
Salary/Wage
Location Address:
City State ZIP Code
Contact Person
Phone Number:
Reason For Leaving:
Were you subject to the FMCSR while employed?
- Yes
- No
Was your job designated as a safety sensitive function in any DOT regulated mode subject to the drug and alcohol testing requirements of 40CFR part 40?
- Yes
- No
Previous Employer #3
- Yes
- No
Previous Employer #3
Employer Name:
From (mm/yyyy):
To (mm/yyyy):
Position Held:
Salary/Wage
Location Address:
City State ZIP Code
Contact Person
Phone Number:
Reason For Leaving:
Were you subject to the FMCSR while employed?
- Yes
- No
Was your job designated as a safety sensitive function in any DOT regulated mode subject to the drug and alcohol testing requirements of 40CFR part 40?
- Yes
- No
Previous Employer #4
- Yes
- No
Previous Employer #4
Employer Name:
From (mm/yyyy):
To (mm/yyyy):
Position Held:
Salary/Wage
Location Address:
City State ZIP Code
Contact Person
Phone Number:
Reason For Leaving:
Were you subject to the FMCSR while employed?
- Yes
- No
Was your job designated as a safety sensitive function in any DOT regulated mode subject to the drug and alcohol testing requirements of 40CFR part 40?
- Yes
- No
Previous Employer #5
- Yes
- No
Previous Employer #5
Employer Name:
From (mm/yyyy):
To (mm/yyyy):
Position Held:
Salary/Wage
Location Address:
City State ZIP Code
Contact Person
Phone Number:
Reason For Leaving:
Were you subject to the FMCSR while employed?
- Yes
- No
Was your job designated as a safety sensitive function in any DOT regulated mode subject to the drug and alcohol testing requirements of 40CFR part 40?
- Yes
- No
Previous Employer #6
- Yes
- No
Previous Employer #6
Employer Name:
From (mm/yyyy):
To (mm/yyyy):
Position Held:
Salary/Wage
Location Address:
City State ZIP Code
Contact Person
Phone Number:
Reason For Leaving:
Were you subject to the FMCSR while employed?
- Yes
- No
Was your job designated as a safety sensitive function in any DOT regulated mode subject to the drug and alcohol testing requirements of 40CFR part 40?
- Yes
- No
Previous Employer #7
- Yes
- No
Previous Employer #7
Employer Name:
From (mm/yyyy):
To (mm/yyyy):
Position Held:
Salary/Wage
Location Address:
City State ZIP Code
Phone Number:
Reason For Leaving:
Were you subject to the FMCSR while employed?
- Yes
- No
Was your job designated as a safety sensitive function in any DOT regulated mode subject to the drug and alcohol testing requirements of 40CFR part 40?
- Yes
- No

Save and Continue Later

The following must be completed by truck driver applicants
*Includes vehicles having a GVWR of 26,001 lbs. or more: vehicles designed to transport fifteen(15) or more passengers, or any size vehicle used to transport hazardous materials in a quantity requiring placarding. ^The Federal Motor Carrier Safety Regulations (FMCSR) apply to anyone operating a motor vehicle on a highway in Interstate commerce to transport passengers or property when the vehicle:
1. 1. Weighs or has a GVWR of 10,001 lbs. or more:
2. 2. is designed or used to transport nine (9) or more passengers: or
3. 3. is of any size and is used to transport hazardous materials in a quantity requiring placarding.
Are you applying for a truck driving position? If not, choose "No" and continue to the next page*
- Yes
- No
Have you had any accidents in the past three (3) years or more?*
- Yes
- No
Please list below:*
Date Details Fatalities Injuries
Have you had any traffic convictions and/or forfeitures in the past three (3) years? (Other than parking violations.)*
- Yes
- No
Please list below:*
Location Date Charge Penalty
Experience and Qualifications
Drivers License(s)*
State License # Type Expiration Date
Have you ever been denied a license or permit to operate a motor vehicle?*
- Yes
- No
Has any license, permit or privilege ever been suspended or revoked?*
- Yes
- No
Please provide more details:*
Driving Experience
List
Type Date Approximate number of miles (total)
Driving Experience:
List
Type Date Approximate number of miles (total)
Driving Experience::
List
Type Date Approximate number of miles (total)
Driving Experience.
Type Date Approximate number of miles (total)
List the states you have operated in for the past five (5) years:*
What special courses or training do you have that will help you as a driver?
Which safe operating awards do you hold and from whom?
What trucking, transportation, or other experience do you have that may help you in your work for this company?
List other courses and training not asked elsewhere in this application:

Save and Continue Later

Notice To Applicant
This employer complies with the Americans with Disabilities Act of 1990. During the interview process you may be asked questions concerning your ability to perform job-related functions. If you are given a conditional offer of employment you may be required to complete a post-job offer medical history questionnaire and/or undergo a medical examination. If required, all entering employees in the same job category will be subject to the same medical questionnaire and/or examination.

All information will be kept confidential and in separate files.Applicants accepted for employment should clearly understand that while we make an effort to provide steady, continuous work, we have no employment contracts and we cannot guarantee the permanence of any postion. Job tenure can be affected by many factors including business/economic conditions, changes in law or Employer policies, conformity to work rules, job performance, etc., and of course, employees may elect to leave of their own accord to seek other jobs.

We conduct our business with the highest possible degree of safety and efficiency. Because of this, the employer may require applicants for employment to undergo blood and/or urinalysis screening for drug or alcohol use as part of our pre-placement physical examination. In addition, all employees of the Employer are subject to random blood tests and/or urinalysis screening for drug or alcohol use.
To Be Read and Signed By All Applicant
I certify that the answers given herein are true and complete to the best of my knowledge. I authorize the investigation of my background and all matters contained in this application and hereby give the Employer permission to contact schools, previous employers, references, and other, and hereby release the Employer from any liability as a result of such contact and release all such persons or companies or corporations supplying information from all liability for all damages on account of supplying such information. I understand that misrepresentations, omissions of fact or incomplete information requested in this application may remove me from futher consideration for employment or, if employed by the Employer, may result in termination of my empolyment. I agree to furnish such additional information and complete such examinations as may be required to complete this application

In consideration of my employment, I agree to conform to the rules and regulation of the Employer. I understand that my employment with the Employer is for no specific term, and that my employment, compensation, benefits can be terminated, with or without cause, and with or without notice, at any time, for any reason, at the option of the Employer or myself.

I further understand that no oral promise, Employer policy, custom, business practice or other procedure ( including the Employer's Employee Handbook or any personal manuals) constitutes an employment contract or modification of the at-will employment relationship between the Employer and me.

The contents of any Employee Handbook or personnel manuals, as well as other Employer policies and practices, are subject to change or modification by the Employer, solely at its discretion, without notice.

I also understand that no manager, supervisor, or company representative(s) other than the Employer's two Directors, has any authority to enter into any employment agreement for any specified time period, or to make any oral or written agreement contrary to the foregoing.

I understand all notices to applicants above, and I agree to submit to testing for drug or alcohol use in accordance with the Employer's policies.
Consent*
I Acknowledge that I have read and understand the contents of this document
Date*
MM slash DD slash YYYY
Full Name (Printed):*
**This application will remain active for thirty (30) days. Any applicant wishing to be considered for employment beyound thirty (30) days should reapply. This Employer is an equal opportunity employer. We adhere to a policy of making employment decisions without regard to race, color, age, sex, sexual orientation, religion, national origin, disability, veteran or marital status, or any other status or condition protected by applicant's federal or statutes, except where a bona fide occupational qualification exists. Your opportunity for employment with the Employer depends solely upon your qualifications. This application will remain active for thirty (30) days. Any applicant wishing to be considered for employment beyound thirty (30) days should reapply.

Save and Continue Later

Driver's Rights Pertaining to Release of Driver Information Under Regulation 391.23
Motor carriers have the responsibility to make the following investigations and inquiries with respect to each driver employed, other than a person who has been a regularly employed driver of the motor carrier for a continuous period which began before January 1, 1971.
1. 1a. An inquiry into the driver's driving record during the preceding three (3) years to the appropriate agency of every State in which the driver held a motor vehicle operator's license or permit during those three (3) years;
2. 2a. An investigation of the driver's employment record during the preceding three (3) years.
3. 2b. A copy of the driver record(s) obtained in response to the inquiry or inquiries to each State driver record agency as required must be placed in the Drivers Qualification File within 30 days of the date the driver's employment begins and be retained in compliance with 391.51
4. 2c. Replies to the investigations of the driver's safety performance history must be placed in the Driver Investigation History File within 30 days of the date the driver's employment begins. This goes into effect after October 29, 2004.
5. 2d. Prospective motor carrier must investigate the information from all previous employers of the applicant that employed the driver to operate a CMV within the previous three years, This information must cover general driver identification and employment verification information, data elements as specified in 390.15 for accident involving the driver that occurred in the three-year period preceding the date of the employment application, and any accident the previous employer may wish to provide.
6. 2e. Prospective motor carrier must investigate the information from all previous DOT regulated employers that employed the driver within the previous three years from the date of the employment application in a safety sensitive function that required alcohol and controlled substance testing specified by 49 CFR Part 40.
Drivers have the following rights:
1. 1. The right to review information provided by previous employers.
2. 2. The right to have errors in the information corrected by the previous employer and for that employer to resend the corrected information to the prospective employer.
3. 3. The right to have a rebuttal statement attached to the alleged erroneous information, if the previous employer and the driver cannot agree on the accuracy of the information.
Drivers who wish to review previous employer provided investigative information must submit a written request to the prospective employer when applying or as late as 30 days after employed or being notified of denial of employment. The prospective employer must provide this information to the applicant within five business days of receiving the written request. If the driver has not arranged to pick up or receive the requested records within 30 days of the prospective employer making them available, the prospective motor carrier may consider the driver to have waived his/her request to review the records.

Drivers wishing to request correction of erroneous information in records must send the request for the correction to the previous employer that provided the records. After October 29, 2004, the previous employer must either correct and forward the information to the prospective motor carrier employer or notify the driver within 15 days of receiving the driver's request to correct the data that it does not agree to correct the data. Drivers wishing to rebut information in records must send the rebuttal to the previous employer with instruction to include the rebuttal in the driver's Safety Performance History.
Consent*
I Acknowledge that I have read and understand the contents of this document
Date*
MM slash DD slash YYYY
Full Name (Printed):*

Save and Continue Later

Drug and Alcohol
Section I. To be completed by the new employer, signed by the employee, and transmitted to the previous employer
Employee Name:*
First Last
SSN:*
I hereby authorize release of information from my Department of Transportation regulated drug and alcohol testing records by my previous employer, listed in Section I-B. This release is in accordance with DOT Regulation 49 CFR, Part 40, secyion 40.25. I understand that information to be released in Section II-A by my previous employer, is limited to the Folloeing DOT regulated testing items:
1. 1. Alcohol tests with a result of 0.04 or higher
2. 2. Verified positive drug tests.
3. 3. Refusals to be tested.
4. 4. Other violations of DOT agency drug and alcohol testing regulations.
5. 5. Information obtained from previous employers of a drug and alcohol rule violation.
6. 6. Documentation, if any, of completion of the return to duty process following a rule violation.
Consent*
I hereby authorize the release of information regarding my drug and alcohol testing records from my previous employer.
Date*
MM slash DD slash YYYY
Full Name (Printed):*
Previous Employer Info*
Employer Name City, State, Zip Code Phone Number
The following section is to be completed by the previous employer and transmitted by mail or fax to the new employer. For your reference the questions and information is listed below.
1. 1. Did the employee have alcohol tests with a result of 0.04 or higher? Y/N
2. 2. Did the employee have verified positive drug tests? Y/N
3. 3. Did the employee refuse to be tested? Y/N
4. 4. Did the employee have other violations of DOT agency drug and alcohol testing regulations? Y/N
5. 5. Did a previous employer report a drug and alcohol rule violation to you? Y/N
6. 6. If you answered "yes" to any of the above items, did the employee complete the return to duty process? Y/N
NOTE: If you answered "yes" to idem 5, you must provide the previous employer's report. If you answered "yes" to idem 6, you must also transmit the appropriate return to duty documentation ( e.g., SAP report(s), Follow up testing records).
- Name of person providing the information?
- Title:
- Phone Number:
- Date:

Save and Continue Later

MAC R BEHNKE RENTALS LTD (dba BEHNKE LOGISTICS & BEHNKE DEDICATED LLC) BEHNKE WAREHOUSE INC.
- 180 S Union St.
- Battle Creek, MI 49014
- Phone: (269) 962-0034
Past Record Release
Having made application for employment with the above-referenced company, I hereby authorize investigation of my past employment record to ascertain any and all information and hereby release my present and past employers and all persons whomsoever from any damage resulting from furnishing said information.
Consent*
I Acknowledge that I have read and understand the contents of this document
Date*
MM slash DD slash YYYY
Full Name (Printed):*

Save and Continue Later

Request / Consent for information from Previous Employer(s) / Carriers for Alcohol and Controlled Substances Testing Records (with changes in Parts 390 and 391 of the FNCSA)
Consent*
I Acknowledge that I have read and understand the contents of this document
Date*
MM slash DD slash YYYY
Full Name (Printed):*
SSN*
I, the above-mentioned signer, hereby authorize the release of all known information pertaining to my alcohol and Controlled substances testing / training records to Mac R Behnke Rentals LTD / Behnke Warehouse Inc.
DOT Drug and Alcohol Release
In accordance with DOT Regulation 49 CFR Part 391.23, I authorize the release of information from my DOT regulated drug and alcohol testing records for the sole purpose of transmitting such records to the above-referenced company. I authorize release of the following information concerning DOT drug and alcohol testing violations including pre-employment tests during the past three years: (i) alcohol tests with a result of 0.04 or higher; (ii) verified positive drug tests; (iii) refusals to be tested (including verified adulterated or substituted results; (iv) other violations of DOT drug and alcohol testing regulations; (v) information obtained from previous employers of a drug and alcohol rule violation(s); and (vi) documents, if any, of completion of return-to-duty process following a rule violation.

The information that I have authorized for review involves tests required by DOT. If any carrier (company/school) furnishes information concerning items (i) through (vi) above, I also authorized\ the release and furnished dates of my negative drug and / or alcohol tests with results below 0.04 during the three year period and the name and phone number of any substance abuse professional who evaluated me during the past three years.

Save and Continue Later

THE BELOW DISCLOSURE AND AUTHORIZATION LANGUAGE IS FOR MANDATORY USE BY ALL ACCOUNT HOLDERS
IMPORTANT DISCLOSURE REGARDING BACKGROUND REPORTS FROM THE PSP ONLINE SERVICE
In connection with your application for emplyment with Mac R Behnke Rentals ( Behnke Dedicated) ( " Prospective Employer"), Prospective Employer, its employees, agents or contractors may obtain one or more reports regarding your driving, and safety inspection history from the Federal Motor Carrier Safety Administration (FMCSA).

When the application for employment is submitted in person, if the Prospective Employer uses any information it obtains from FMCSA in a decision to not hire you or to make any other adverse employment decision regarding you, the Prospective Emplyer 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, the Prospective Employer will notify you that the action has been taken and that the action was based in part or in whole on this report.

When the application for employment is submitted by mail, telephone, computer, or other similar means, if the Prospective Employer uses any information it obtains from FMCSA in a decision to not hire you or to make any other adverse employment decision regarding you, the Prospective Employer must provide you within three business days of taking adverse action oral, written or electronic notification: that adverse action has been taken based in whole or in part on information obtained from FMCSA; the name, address, and the toll free telephone number of FMCSA; that the FMCSA did not make the decision to take the adverse action and is unable to provide you the specific reasons why the adverse action was taken; and that you may, upon providing proper identification, request a free copy of the report and may dispute with the FMCSA the accuracy or completeness of any information or report. If you request a copy of a driver record from the Prospective Employer who procured the report, then within 3 business days of receiving your request, together with proper identification, the Prospective Employer must send or provide to you a copy of your report and a summary of your rights under the Fair Credit Reporting Act.

Neither the Prospective Employer nor the FMCSA contractor supplying the crash and safety information has the capability to correct any safety data that appears to be incorrect. You may challenge the accuracy of the data by submitting a request to https://dataqs.fmcsa.dot.gov. If you challenge crash or inspection information reported by a State, FMCSA cannot change or correct this data. Your request will be forwarded by the DataQs system to the appropriate State for adjudication.

Any crash or inspection in which you were involved will display on your PSP report. Since the PSP report does not report, or assign, or imply fault, it will include all Commerial Motor Vehicle (CMV) crashes where you were a driver or co-driver and where those crashes were reported to FMCSA, regardless of fault. Similarly, all inspections, with or without violations, appear on the PSP report. State citations associated with Federal Motor Carrier Safety Regulations (FMCSR) violations that have been adjudicated by a court of law will also appear, and remain, on a PSP report.

The Prospective Employer cannot obtain background reports from FMCSA without your authorization.
Authorization
If you agree that the Prospective Employer may obtain such background reports, please read the following and sign below:

I authorize Mac R Behnke Rentals (Behnke Dedicated) ("Prospective Employer") to access the FMCSA Pre-Employment Screening Program (PSP) system to seek information regarding my commercial driving safety record and information regarding my inspection history. I understand that I am authorizing 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 the Prospective Employer to make a determination regarding my suitability as an employee.

I further understand that neither the Prospective Employer 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 challenge 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.

I understand that any crash or inspection in which I was involved will display on my PSP report. Since the PSP report does not report, or assign, or imply fault, I acknowledge it will include all CMV crashes where I was a driver or co-driver and where those crashes were reported to FMCSA, regardless of fault. Similarly, I understand all inspections with or without violations, will appear on my PSP report, and State citations associated with FMCSA violations that have been adjudicated by a court of law will also appear, and remain, on my PSP report. I have read the above Disclosure Regarding Background Reports provided to me by Prospective Employer and I understand that if I sign this Disclosure and Authorization, Prospective Employer may obtain a report of my crash and inspection history. I hereby authorize Prospective Employer and its employees, authorized agents, and/ or affiliates to obtain the information authorized above.
Consent*
I Acknowledge that I have read and understand the contents of this document
Date*
MM slash DD slash YYYY
Full Name (Printed):*

Save and Continue Later

Annual Certificate of Violations and Review of Driving Record
I certify that the following is true and a complete list of traffic violations ( other than Parking violations) for which I have been convicted or forfeited bond or collateral during the past 12 months.
Name*
License #*
State:
Please select below:*
- Yes, I have had violations in the past.
- No, I have NOT had any violations in the past.
Violations:*
Date of Conviction Offense Location Type of Motor Vehicle Operated
Consent*
If no violations are listed above, I certify that I have not been convicted or forfeited bond or collateral on account of any violation required to be listed during the past 12 months.
Date of Certification*
MM slash DD slash YYYY
Full Name (Printed):*

Save and Continue Later

Driver's Data Sheet
As required under the FMCSR a motor carrier is required to have a written statement from the driver of his / her driving and on duty time for the preceding seven days. This requirement includes all new-hire drivers and intermittent Drivers.
Driver's Name*
First Last
SSN:*
Driver's Address*
Street Address Address Line 2 City State ZIP Code
Consent*
I Acknowledge that I have read and understand the contents of this document
Date*
MM slash DD slash YYYY
Full Name (Printed):*
Please provide an example of your driving and on duty time over a seven day period:*
Day(1-7): Date: Total Hours:
When were you released from work?*
MM slash DD slash YYYY

Save and Continue Later

Certification of Compliance With Driver License Requirements
DRIVER REQUIREMENTS: As required under the FMCSR Part 383 and 391 every driver who operates a CMV must Comply with certain regulations. They are as follows:
1. 1. POSSESES ONLY ONE LICENSE: You, as a commercial vehicle driver, may not possess more than one motor vehicle operator's license.
2. 2. NOTIFICATION OF LICENSE SUSPENSION, OR CANCELLATION:
  1. a. A driver is required under the FMCSR Section 392.42 and 383.33 to notify his / her employer the NEXT BUSINESS DAY of any revocation or suspension of your driver's license.
  2. b. Section 383.31 of the FNCSR requires the driver who violates a state or local traffic law (other than parking), must report it within 30 days to:
    1. 1. Your employing motor carrier, and
    2. 2. The state that issued your license ( if the violation occurred in a state other than the one which issued you license). The notification to both the employer and state must be in writing.
I only possess one license as listed below:
License #*
State:*
Exp. Date:*
MM slash DD slash YYYY
Driver Certification*
I certify that I have read and understand the above requirements.
Date*
MM slash DD slash YYYY
Full Name (Printed):*

Save and Continue Later

To Be Read and Signed by Applicant
It is agreed and understood that any misrepresentation given on this application shall be considered an act of dishonesty. It is agreed and understood that the motor carrier or his agents may investigate the applicant's background to ascertain any and all information of concern to applicant's record, whether same is of record or not, and applicant releases employers and persons named herein from all liability for any damages on account of his furnishing such information. It is also agreed and Understood that under the Fair Credit Reporting Act, Public Law 91-508, I have been told that this investigation may include an investigating Consumer Report, including information regarding my character, general reputation, personal characteristics, and mode of living.

I agree to furnish such additional information and complete such examinations as may be required to complete my application file. It is agreed and understood that this Application for Qualification in no way obligates the motor carrier to employ or hire the applicant. It is agreed and understood that if qualified and hired, I may be on a probationary period during which time I may be disqualified without recourse.

Additionally, it should be noted that falsification or omission of information is grounds for failure to hire or for termination.

This certifies that this application was completed by me, and that all entries on it and information in it are true and complete to the best of my knowledge.

Only complete applications will be considered. If an applicant submits additional information not asked for on this application, it may cause rejection of such application.
Consent*
I certify that I have read and understand the above requirements.
Date*
MM slash DD slash YYYY
Full Name (Printed):*

Save and Continue Later

Confidential
Background Check Authorization
Name*
First Last
Current Address*
Street Address Address Line 2 City State ZIP Code
Previous Address
Street Address Address Line 2 City State ZIP Code
SSN:*
D.O.B*
MM slash DD slash YYYY
Phone #*
Drivers License #*
State of Issuance*
The information contained in this application is correct to the best of my knowledge. I hereby authorize Behnke Warehouse, Inc or Mac R Behnke Rentals LTD and its designated agents and representatives to conduct a comprehensive review of my background causing a consumer report and/or an investigative consumer report to be generated for employment and/or volunteer purposes. I understand that the scope of the consumer report / investigative consumer report may include, but is not limited to the following areas: verification of social security number; credit report, current and previous residences; employment history, education background, character references; drug testing, civil and criminal history records from any criminal justice agency in any or all federal, state, county jurisdictions; driving records, birth records, and any other public records.

I further authorize any individual, company, firm, corporation, or public agency to divulge any and all information, verbal or written, pertaining to me, to Behnke Warehouse, Inc or Mac R Behnke Rentals LTD or its agents.

I further authorize the complete release of any records or data pertaining to me which the individual, company, firm, corporation, or public agency may have, to include information or data received from other sources. Behnke Warehouse, Inc or Mac R Behnke Rentals LTD and its designated agents and representatives shall maintain all information received from this authorization in a confidential manner in order to protect the applicants personal, including, but not limited to, addresses, social security numbers, and dates of birth.
Consent*
I certify that I have read and understand the above requirements.
Date:*
MM slash DD slash YYYY
Full Name (Printed):*

Save and Continue Later

Behnke Dedicated & Logistics ® 2019 | All Rights Reserved