Nationwide Express | Dedicated to your commitments | Truckload, Warehousing, Logistics

If you are interested in becoming a Nationwide Express driving associate, please complete the online application located below in full or call 888-441-4121.

Driver Position Applying For	Company Driver Owner / Operator

Driver Information
Name
Social Security Number
Date of Birth (mm/dd/yyyy)
Address
City
State
Zip Code

Contact Information	At least one phone number must be provided
Home Phone
Cell Phone
Pager (with code)
E-mail Address

Driving/Endorsement Information
License Number
State
Endorsements
Year OTR Experience

Accidents/Driving Infractions	Please list all infractions with dates in designated boxes below, separated by commas
Accidents
Speeding Tickets
DUI/DWI
Careless/Reckless
Felony/Misdemeanor

Have you ever tested positive for or refused a drug screen?	Yes No If Yes, when?

Employment History	Please complete the sections below as they pertain to your employment history. Nationwide Express requires a 10 year work history.
Most Recent Employment
Company Name
Name of Contact
Contact Phone #
City
State
Years OTR
Start & End Dates	Start: End:
Number of States

Employment 1
Company Name
Name of Contact
Contact Phone #
City
State
Years OTR
Start & End Dates	Start: End:
Number of States

Employment 2
Company Name
Name of Contact
Contact Phone #
City
State
Years OTR
Start & End Dates	Start: End:
Number of States

Employment 3
Company Name
Name of Contact
Contact Phone #
City
State
Years OTR
Start & End Dates	Start: End:
Number of States

Employment 4
Company Name
Name of Contact
Contact Phone #
City
State
Years OTR
Start & End Dates	Start: End:
Number of States

Employment 5
Company Name
Name of Contact
Contact Phone #
City
State
Years OTR
Start & End Dates	Start: End:
Number of States

I certify that I personally completed this application and that all of the information is true and correct. I hereby request and authorize any company that receives this application to cause to be conducted, at any time, an investigation of my background for employment purposes, which may include, but is not limited to, any information relating to my character, general reputation, personal characteristics, mode of living, criminal history, past work experience, educational background, alcohol or drug test results, or failure to submit to an alcohol or drug test, or any other information about me which may reflect upon my potential for employment gathered from any individual, organization, entity, agency, or other source which may have knowledge concerning any such items of information. I have completed this application of my own free will and hold Nationwide Express harmless of all liability for providing this application for my use.

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