Golden Gate Transport LLC

1

Personal Information

Full Legal Name *

Date of Birth *

Email Address *

Phone Number *

Street Address *

City *

State *

ZIP Code *

2

Emergency Contact

Contact Name *

Relationship *

Contact Phone *

3

CDL & Credentials

Applicant Type *

Position Applied For *

CDL Class *

CDL Number *

Issuing State *

Years of CDL Experience *

Medical Card Number *

Medical Card Expiration *

TWIC Card # (if applicable)

I have a Hazmat endorsement

4

Accident & Violation History — Prior 3 Years (49 CFR §391)

5

DOT Drug & Alcohol Testing Consent (49 CFR Part 382)

By submitting this application I consent to all DOT-mandated drug and alcohol testing as a condition of employment or contractor status with Golden Gate Transport LLC.

Prior drug or alcohol violations with any employer in the last 3 years? *

YesNo

6

Previous Employment

Most Recent Employer

Company Name *

Years Employed *

Employer Phone

7

Required Documents Checklist

Check off each document you have ready and optionally attach the matching file (PDF, JPG, or PNG). Photos are optimized automatically, and all documents are merged into your application PDF.

8

Additional Information

Notes / Comments

9

Authorization, Certification & Applicant Signature

I certify that all information provided on this application is true, complete, and accurate to the best of my knowledge and belief. I understand that any misrepresentation, omission, or falsification is grounds for rejection or termination. I authorize Golden Gate Transport LLC (USDOT: 3825402 / MC 1385720) to verify prior employment, obtain applicable MVR and PSP reports, conduct background checks, and arrange DOT-required testing in accordance with 49 CFR Parts 382, 383 & 391.

I have read and agree to the authorization and certification above. *

Electronic Signature (Full Legal Name) *

Date Signed *

Draw Your Signature (finger or mouse)

Sign above

Driver Employment Application