ProWorx Staffing — CDL Driver Application

✅

Application Submitted!

Thank you for applying with ProWorx Staffing. A member of our team will review your application and be in touch within 1–2 business days.

Personal Information

First Name *

Last Name *

Email Address *

Phone Number *

Street Address *

Apt / Unit

City *

State *

ZIP Code *

Date of Birth *

Social Security # (last 4)

Emergency Contact Name *

Emergency Contact Phone *

Relationship

CDL License & Endorsements

CDL License Class *

License Number *

Issuing State *

Expiration Date *

Endorsements (select all that apply)

Medical Card Expiration *

TWIC Card?

Yes No

📎

Required Document Uploads

Please upload clear photos or scans of the documents below. Accepted formats: JPG, PNG, PDF. Max 10MB per file.

Driver's License — Front *

📄

Click to upload front of license

JPG, PNG, or PDF · Max 10MB

Driver's License — Back *

📄

Click to upload back of license

JPG, PNG, or PDF · Max 10MB

DOT Medical Card (if applicable)

🏥

Click to upload medical card

JPG, PNG, or PDF · Max 10MB

📋 What We Need

Valid CDL (not expired)
Front & back clearly visible
Medical card current & valid
Image must be readable

Safety & DOT Compliance

Any accidents in the last 3 years? *

Yes No

Any moving violations in the last 3 years? *

Yes No

License ever suspended or revoked? *

Yes No

Failed a DOT drug/alcohol test? *

Yes No

If yes to any above, please explain

Availability & Preferences

Available Start Date *

Employment Type Sought *

Desired Pay Rate ($/hr or $/mile)

Willing to travel overnight?

Yes No Occasionally

Shift Preference

Days Nights Weekends Flexible

Preferred Work Area / Region

Additional Notes or Comments

Signature (type your full legal name) *

Date *

By submitting this application, I certify that all information provided is true and complete. I authorize ProWorx Staffing to verify my employment history, driving record, and references. I understand that false or misleading information may result in disqualification from employment.

Ready to submit? ProWorx Staffing — 1-855-PRO-WORX (1-855-776-9679) · [email protected]