SEJ TRUCKING LLC

Driver Employment Application

PO BOX 7603, SPRECKELS, California 93962 • DOT 3722565 • MC 1508845

831-229-4614 • WWW.SEJTRUCKING.COM

Section 1 of 12 — Driver Identification

Your progress is saved automatically on this device.

Section 1 — Driver Identification

Per 49 CFR §391.21 — all fields marked * are required.

First Name *

Middle Name

Last Name *

Date of Birth *

SSN

Phone *

Email *

Current Address

Street Address *

City *

State *

ZIP *

Resided at current address less than 3 years?

Emergency Contact

Contact Name *

Contact Phone *