Driver Pre Employment Application
THANK YOU FOR APPLYING WITH GOLD COAST LOGISTICS ONE OF OUR RECRUITERS WILL BE IN CONTACT WITH YOU TO DISCUSS OUR OPPORTUNITIES

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Pre-QualifyBackground Record CheckI hereby authorizes GoldCoast Logistics to request my driving/background records for purposes of investigation as required by Section 391.23 of the FMCSR. You are released from any and all liability which may result from furnishing such information. In accordance with the provisions of Section 604 and 607 of the Fair Credit Reporting Act, Public Law 91‐ 508, as amended by the Consumer Credit Reporting Act of 1996 (Title II, Subtitle D, Chapter1, of Public Law 104‐208), I hereby certify the following: The applicant has authorized in writing the procurement of this report. The applicant has been informed in a separate written disclosure that a consumer report may be obtained for driver qualification purposes. The information requested below will be used for a “permissible purpose” (i.e., information for qualification purposes) and will be used for no other purpose. The information being obtained will not be used in violation of any federal or state equal opportunity law or regulation; before making an adverse action based in whole or in part on the report, the applicant will receive a copy of the requested report and the summary of consumer rights as provided with the report by the consumer‐reporting agency. I also hereby certify that this report request and the above applicant’s release notice meet the definition of “permissible uses” of state motor vehicle records under the provision of the Driver’s Privacy Protection Act of 1994 (Public Law 103‐322, Title XXX, Section 300002(a)). * *
Date: *
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First Name *
Last Name *
Address, City, State, Zip Code *
Phone number * *
Email Address *
DRIVERS LICENSES NUMBER * *
Driver's Licenses Expiration Date *
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WHAT STATE WAS THE DRIVERS LICENSES ISSUE * *
DATE OF BIRTH *
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How many years of experience do you have? *
Which of the following opportunity are you interested? *
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A copy of your responses will be emailed to the address you provided.
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