108 Plunkett Drive
Zelienople, PA 16063
Toll Free: (800) 424-2737
Voice: (412) 821-1395 Fax: (412) 821-6201
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Home
About Us
Equipment
Services
Get a Quote
Contact Us
E-Mail Us
Employment Application – PDF Download
Employment Application – Online Form
Photo Gallery
Login
Employment Application
Please fill out this form in its entirety to be considered for employment at Reinsfelder, Inc.
Type of Application
*
Company Driver
Lease Driver
Owner/Operator
Name
*
First
Last
Email
*
Date of Application
*
Social Security Number
*
Address
*
Street Address
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
Zip Code
Home Phone
*
Cell Phone
*
Date of Birth
*
Have you ever been convicted of a felony?
*
No
Yes
If YES, what was the year of the felony?
If YES, what type of conviction:
Have you ever been convicted of a DUI or controlled substance?
*
No
Yes
If YES, what was the year of the conviction?
If YES, what type of conviction?
Have you ever tested positive on a drug screening exam?
*
No
Yes
Are you capable of performing heavy manual labor and tarping steel and machines?
*
Yes
No
Do you have any Over-The-Road (OTR) experience?
*
Yes
No
If YES, how many years?
Do you have any flatbed experience?
*
Yes
No
If YES, how many months?
CDL#
*
State
*
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
Endorsements
Expiration Date
Number of tickets in the last 5 years:
*
Number of accidents in the last 5 years
*
Employment History
Please list employers for the last 3 years in the sections below:
Most Recent Employer
*
From (Date)
*
To (Date)
*
Employer Address
*
Street Address
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
Zip Code
Employer Phone
*
List types of trailers used
*
May we contact this employer?
*
Yes
No
Rate of Pay:
*
Why did you leave/do you wish to leave?
*
Next Most Recent Employer
From (Date)
To (Date)
Employer Address
Street Address
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
Zip Code
Employer Phone
List types of trailer used:
May we contact this employer?
Yes
No
Rate of Pay:
Why did you leave?
Next Most Recent Employer
From (Date)
To (Date)
Employer Address
Street Address
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
Zip Code
Employer Phone
List types of trailer used:
May we contact this employer?
Yes
No
Rate of Pay:
Why did you leave?
Signature
By submitting online form via email, this certifies that this application was completed by me, and that all entries on it and information in it are true and complete to the best of my knowledge, I authorize REINSFELDER, INC. to make such investigations and inquiries of my personal, employment, financial, or medical history, and other related matters as may be necessary in arriving at an employment decision. (Generally, inquiries regarding medical history will be made only if and after a conditional offer of employment has been extended.) I hereby release employers, schools, healthcare providers, and other persons from all liability in responding to inquiries and releasing information in connection with my application. I understand that information I provide regarding current and/or previous employers may be used and those employer(s)will be contacted for the purpose of investigating my safety performance history as required by 49 CFR 391.23 (a) and (e). I understand that I have the right to: * Review information provided by previous employers * Have errors in the information corrected by previous employers and for those previous employers to re-send the corrected information to the prospective employer * Have a rebuttal statement attached to the alleged erroneous information, if the previous employer(s) and I cannot agree on the accuracy of the Information In the event of employment, I understand that false or misleading information given in my application or interview may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the company. To release the following information to Reinsfelder, Inc. for the purposes of investigation as required by section §391.23 and allowed by section §383.35 of the Federal Motor Carrier Safety Regulations. You are released from any and all liability, which may result from furnishing such information.
Name:
*
Today's Date:
*