Please enable JavaScript in your browser to complete this form.123456789101112131415Thank you for your interest in:AQT Logistics Please complete our online operator work history. Incomplete information will delay the processing of your work history or prevent it from being submitted. If you are a fleet owner and have a driver applying to AQT Logistics, only the driver needs to complete the application. As a fleet owner, you do not need to complete the application unless you are intending to join AQT Logistics as an owner-operator. Please make sure you are entering your name exactly as it appears on your CDL. To fill out this form, you will need to know the following: Social Security Number. Home address history for the past 3 years. Current drivers license number and drivers license history for the past 3 years. Employment history up to 10 years. History of traffic accidents, violations, and / or convictions from the last 5 years (including DUI or reckless driving convictions and license suspensions). Military history (if applicable). To qualify with AQT Logistics, you must meet the following criteria: Owner Operator Minimum Requirements. Must be at least 23 years of age. Class A (or Class B for Expedited) CDL with HazMat (H) or combination (X) endorsement. No more than two at-fault accidents and two motor vehicle violations within the previous 36 months, or no more than one at-fault accident and three motor vehicle violations during the previous 36 months. No involvement in a preventable DOT recordable accident in the past 12 months. Operators must have one year (six months for Expedited) of verifiable over-the-road driving within the past three years or two years verifiable experience in the last 5 years, with a Class A (or Class B for Expedited) CDL using the type of equipment similar to what you will be operating at AQT Logistics. No felony convictions within the past 7 years. All other felony and misdemeanor charges are reviewed on a case-by-case basis. No positive drug or alcohol test including refusals and pre-employment results. No suspensions of more than 30 days for moving violations in the last 36 months. No more than one serious violation as defined on Table 2 of section 383.51 of the FMCSR handbook within the previous 36 months prior to qualification. No railroad-highway grade crossing offenses as defined on Table 3 of section 383.51 of the FMCSR handbook within the previous 36 months prior to qualification. No citations or convictions for Reckless Driving or Careless Endangerment during the 36 month period prior to the order date of the MVR. No DUI charges during the 60 month period prior to the order date of the MVR in a personal or non-commercial vehicle and never in a commercial vehicle. Proficient enough in English to understand highway traffic signs and signals, respond to official inquiries, make entries on reports and records, and converse with the public. Provide and maintain proper levels and types of approved insurance during your lease with AQT Logistics including: *Unladen Liability and Occupational Accident coverage or, in some cases, statutory Workers' Compensation coverage are mandatory. If you do not participate in the Unladen Liability and/or CPP (Occupational Accident insurance) programs, you must show comparable Unladen Liability coverage and/or Occupational Accident coverage through acceptable insurance carriers.*If statutory Workers' Compensation coverage is required and you do not participate in the fleet workers' compensation plan (FWCP) program, coverage must be provided by licensed carriers with acceptable interstate coverage. These are minimum operator qualification standards subject to DOT requirements, and AQT logistics may impose more stringent requirements at its option. The decision whether to qualify an operator will be made by AQT Logistics in its sole discretion and on a case-by-case basis. Required entry fields are followed by * NextPersonal Information First Name *Midle NameLast Name *SufixNoneNoneJr.Sr.II.III.IV.V.SNN / SIN *Birthdate *Address Current Address (line 1) *Current Address (line 2)States *AlabamaAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingZip / Postal code *Has it been your address the past 3 years? *YesNoOld Address (Line 1) *Old Address (line 2)States *AlabamaAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingZip / Postal code *Contact If both primary and cell phone are the same type it in both fieldsPrimary Phone *Cell Phone *Email *EmailConfirm EmailCheckboxes *Yes, I agree to receive information concerning future opportunities or promotions from AQT Logistics.PreviousNextLicense Details License Number *Country *USAUSAAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBolivia (Plurinational State of)Bosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongo (Democratic Republic of the)Cook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIran (Islamic Republic of)IraqIreland (Republic of)Isle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea (Democratic People's Republic of)Korea (Republic of)KuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesia (Federated States of)Moldova (Republic of)MonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth Macedonia (Republic of)Northern Mariana IslandsNorwayOmanPakistanPalauPalestine (State of)PanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyrian Arab RepublicTaiwan, Province of ChinaTajikistanTanzania (United Republic of)ThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited Kingdom of Great Britain and Northern IrelandUnited States Minor Outlying IslandsUruguayUzbekistanVanuatuVatican City StateVenezuela (Bolivarian Republic of)Viet NamVirgin Islands (British)Virgin Islands (U.S.)Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland IslandsState *AlabamaAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingLicense Expiration *Physical ExpirationIs this your current driver license? *YesNoIs this a commercial driver license? *YesNoLicense Class *Class AClass AClass AZClass BClass CClass DClass EClass FClass OClass RClass 1Class 2Class 3Class 4Class 5EndorsementsOtherTankerDoubles / TriplesX EndorsementHazMatSpecify *PreviousNextWere you ever in the U.S. military? *YesNoBranch of Service *ArmyArmyArmy ReserveArmy National GuardAir ForceAir Force ReserveAir National GuardMarinesMarine Corps ReserveNavyNavy ReserveCoast GuardCoast Guard ReserveMerchant MarinesNational GuardStart Date *End Date *(If you are currently in the military, please enter the current month and year as the End Date) Rank at dischargeCan you obtain your DD214? *YesNoPreviousNextHave you been employed, contracted, or attended a company orientation in the last 10 years? *YesNoCompany Name *Start Date *End Date *(If you are currently employed/contracted, please enter the current month and year as the End Date) Street Address (line 1)Street Address (line 2)Country *USAUSAAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBolivia (Plurinational State of)Bosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongo (Democratic Republic of the)Cook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIran (Islamic Republic of)IraqIreland (Republic of)Isle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea (Democratic People's Republic of)Korea (Republic of)KuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesia (Federated States of)Moldova (Republic of)MonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth Macedonia (Republic of)Northern Mariana IslandsNorwayOmanPakistanPalauPalestine (State of)PanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyrian Arab RepublicTaiwan, Province of ChinaTajikistanTanzania (United Republic of)ThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited Kingdom of Great Britain and Northern IrelandUnited States Minor Outlying IslandsUruguayUzbekistanVanuatuVatican City StateVenezuela (Bolivarian Republic of)Viet NamVirgin Islands (British)Virgin Islands (U.S.)Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland IslandsState *AlabamaAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingCity *Zip / Postal CodeTelephone *Position Held *Reason for Leaving *Were you terminated/discharged/laid off? *YesNoIs this your current employer? *YesNoMay we contact this employer at this time? *YesNoDid you operate a commercial motor vehicle? *YesNoPreviousNextHave you attended a driver training school? *YesNoStart Date *End Date *If you are currently in school, please enter the current month and year as the End Date) State (Where School is located) *AlabamaAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingSchool Name *City *Country *USAUSAAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBolivia (Plurinational State of)Bosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongo (Democratic Republic of the)Cook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIran (Islamic Republic of)IraqIreland (Republic of)Isle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea (Democratic People's Republic of)Korea (Republic of)KuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesia (Federated States of)Moldova (Republic of)MonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth Macedonia (Republic of)Northern Mariana IslandsNorwayOmanPakistanPalauPalestine (State of)PanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyrian Arab RepublicTaiwan, Province of ChinaTajikistanTanzania (United Republic of)ThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited Kingdom of Great Britain and Northern IrelandUnited States Minor Outlying IslandsUruguayUzbekistanVanuatuVatican City StateVenezuela (Bolivarian Republic of)Viet NamVirgin Islands (British)Virgin Islands (U.S.)Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland IslandsTelephoneWere you subject to the Federal Motor Carrier or Transport Canada Safety Regulations while attending this truck school? *YesNoDid you perform any safety sensitive functions at this truck school, regulated by DOT, and subject to drug and alcohol testing? *YesNoDid you graduate? *YesNoGPAHours of InstructionWhich of the following skills were trained in your program? (Select all that apply)Border CrossingLog BooksFederal Motor Carrier RegulationsHazardous MaterialsPreviousNextHave you attended a school (not related to truck driving) in the last 10 years? *YesNoSchool name *Start Date *End Date *(If you are currently in school, please enter the current month and year as the End Date) City *Country *USAUSAAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBolivia (Plurinational State of)Bosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongo (Democratic Republic of the)Cook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIran (Islamic Republic of)IraqIreland (Republic of)Isle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea (Democratic People's Republic of)Korea (Republic of)KuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesia (Federated States of)Moldova (Republic of)MonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth Macedonia (Republic of)Northern Mariana IslandsNorwayOmanPakistanPalauPalestine (State of)PanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyrian Arab RepublicTaiwan, Province of ChinaTajikistanTanzania (United Republic of)ThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited Kingdom of Great Britain and Northern IrelandUnited States Minor Outlying IslandsUruguayUzbekistanVanuatuVatican City StateVenezuela (Bolivarian Republic of)Viet NamVirgin Islands (British)Virgin Islands (U.S.)Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland IslandsState *AlabamaAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingTelephoneWhat did you study? (accounting, mechanic, etc.) Graduation Date (leave blank if no graduation)PreviousNextHave you been unemployed at any time within the last 10 years? *YesNoStart Date *End Date *(If you are currently unemployed, please enter the current month and year as the End Date) CommentsPreviousNextWhat position are you seeking? *Owner OperatorOwner OperatorFleet OwnerDriver for Fleet OwnerWill you be running as a team? *YesNoHow many years of commercial driving experience do you have? *1123456789+10Do you currently have your own authority? *YesNoAre you a Fleet Owner? *YesNoHow many trucks do you own? *0123456789+10Does your truck(s) have Active Brake Assist? *YesNoEnter make, model, and year of each tractor you own. If you don't own any, enter "None" *If you are a Driver for Fleet Owner, please list the Fleet Owners name:Are you legally eligible for employment in the United States? *YesNoAre you currently employed? *YesNoDo you read, write, and speak English? *YesNoHave you ever qualified or applied with a AQT Logistics company before? *YesNoEnter start and end dates, location, position, and reason for leaving: *Do you have a current TWIC card? *YesNoDo you have a FAST card? *YesNoPlease enter the names of any relatives employed or contracted here:Who referred you?In case of Emergency, notify (list name, address, and phone):DRIVING EXPERIENCE VAN *YesNoFLATBEAD *YesNoSPECIALIZED EQUIPMENT *YesNoREFFEER *YesNoCRIMINAL INFORMATION Driving under the influence of alcohol or any drug or controlled substance under either federal or state law? *YesNoTransportation, possession or unlawful use of any drug or controlled substance while on duty as a driver of a commercial motor vehicle? *YesNoLeaving the scene of an accident? *YesNoA felony involving the use of a motor vehicle? *YesNoCausing a fatality through the negligent operation of a commercial motor vehicle? *YesNoDriving a commercial motor vehicle without obtaining a CDL, without a CDL in your possession or without the proper class of CDL and/or without the necessary endorsements? *YesNoViolating any federal, state or local law governing railroad-highway grade crossings while operating a commercial motor vehicle? *YesNoViolating a driver or vehicle out-of-service order? *YesNoHave you ever tested positive or refused to test on any pre-employment drug or alcohol test during the past 3 years? *YesNoHave you ever tested positive or refused a test required by any state or jurisdiction under its implied consent law? *YesNoHave you ever been convicted of a felony or released from prison in the past? *YesNohave you ever plead "no contest", nolo contendere, or guilty to a crime (i.e. misdemeanor or felony), or been convicted of a crime? *YesNoAre any charges pending against you? *YesNoHas any adjudication of any of the above listed charges or violations ever been postponed, deferred or withheld on good behaviour, or for any other reason? *YesNoHas your license ever been revoked, suspended, canceled or withdrawn, or have you been denied an operator's license, permit or privilege for any reason including failure to pay ticket? *YesNoPreviousNextHave you had any moving violations or traffic convictions in the past 5 Years? *YesNoHow Many?112345Violation Date *Charge / Description: *State *AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingWere you in a Commercial Vehicle? *YesNoPenalty / Fine (Check all that apply) *FineSuspentionRevocationCommunlly ServiceOther Violation Date (Second Violation) *Charge / Description: (Second Violation) *State (Second Violation) *AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingWere you in a Commercial Vehicle? (Second Violation) *YesNoPenalty / Fine (Check all that apply) (Second Violation) *FineSuspentionRevocationCommunlly ServiceOther Violation Date (Third Violation) *Charge / Description: (Third Violation) *State (Third Violation) *AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingWere you in a Commercial Vehicle? (Third Violation) *YesNoPenalty / Fine (Check all that apply) (Third Violation) *FineSuspentionRevocationCommunlly ServiceOther Violation Date (Fourth Violation) *Charge / Description: (Fourth Violation) *State (Fourth Violation) *AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingWere you in a Commercial Vehicle? (Fourth Violation) *YesNoPenalty / Fine (Check all that apply) (Fourth Violation) *FineSuspentionRevocationCommunlly ServiceOther Violation Date (Fifth Violation) *Charge / Description: (Fifth Violation) *State (Fifth Violation) *AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingWere you in a Commercial Vehicle? (Fifth Violation) *YesNoPenalty / Fine (Check all that apply) (Fifth Violation) *FineSuspentionRevocationCommunlly ServiceOtherComments *PreviousNextWere you involved in any accidents/incidents with any vehicle in the last 5 years (even if not at fault)? *YesNoHow Many?12345Date of Accident / Incident *Type of Accident / Incident *Non-InjuryNon-InjuryInjuryFatalityHazmat Accident / Incident *YesNoNature of Accident / Incident *State *AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingCity *Were you in a commercial vehicle? *YesNoWere you at fault? *YesNoWere you ticketed? *YesNoPlease enter detailed information about this accident, whether the accident was chargeable, recordable, reportable, or your fault * Date of Accident / Incident (Second Accident) *Type of Accident / Incident (Second Accident) *Non-InjuryNon-InjuryInjuryFatalityHazmat Accident / Incident (Second Accident) *YesNoNature of Accident / Incident (Second Accident) *State (Second Accident) *AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingCity (Second Accident) *Were you in a commercial vehicle? (Second Accident) *YesNoWere you at fault? (Second Accident) *YesNoWere you ticketed? (Second Accident) *YesNoPlease enter detailed information about this accident, whether the accident was chargeable, recordable, reportable, or your fault (Second Accident) * Date of Accident / Incident (Third Accident) *Type of Accident / Incident (Third Accident) *Non-InjuryNon-InjuryInjuryFatalityHazmat Accident / Incident (Third Accident) *YesNoNature of Accident / Incident (Third Accident) *State (Third Accident) *AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingCity (Third Accident) *Were you in a commercial vehicle? (Third Accident) *YesNoWere you at fault? (Third Accident) *YesNoWere you ticketed? (Third Accident) *YesNoPlease enter detailed information about this accident, whether the accident was chargeable, recordable, reportable, or your fault (Third Accident) * Date of Accident / Incident (Fourth Accident) *Type of Accident / Incident (Fourth Accident) *Non-InjuryNon-InjuryInjuryFatalityHazmat Accident / Incident (Fourth Accident) *YesNoNature of Accident / Incident (Fourth Accident) *State (Fourth Accident) *AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingCity (Fourth Accident) *Were you in a commercial vehicle? (Fourth Accident) *YesNoWere you at fault? (Fourth Accident) *YesNoWere you ticketed? (Fourth Accident) *YesNoPlease enter detailed information about this accident, whether the accident was chargeable, recordable, reportable, or your fault (Fourth Accident) * Date of Accident / Incident (Fifth Accident) *Type of Accident / Incident (Fifth Accident) *Non-InjuryNon-InjuryInjuryFatalityHazmat Accident / Incident (Fifth Accident) *YesNoNature of Accident / Incident (Fifth Accident) *State (Fifth Accident) *AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingCity (Fifth Accident) *Were you in a commercial vehicle? (Fifth Accident) *YesNoWere you at fault? (Fifth Accident) *YesNoWere you ticketed? (Fifth Accident) *YesNoPlease enter detailed information about this accident, whether the accident was chargeable, recordable, reportable, or your fault (Fifth Accident) *PreviousNextCheckboxes *I guaranty the data filled is true, and I allow AQT Logistics to use my personal information Date: *SNN / SIN *Sign here to confirm your application *Clear SignaturePreviousNextBackground Check I *FirstLastAllow AQT llc to run a Background check. On the day of *I give permission till SNN / SIN *Date: *Text...... Name *Birthdate *Date *SignatureClear SignatureNextDriving Record I *FirstLastAllow AQT llc to run a Driving record check. On the day of *I give permission till SNN / SIN *Date: *Text...... Name *Date *Birthdate *SignatureClear SignatureNextWork History I *FirstLastAllow AQT llc to run a Work history check. On the day of *I give permission till SNN / SIN *Date: *Text...... Name *Birthdate *Date *SignatureClear SignatureSingle Line TextSubmit