JAX Express – Driver Application

🚛 Owner-Operator Friendly

💰 Competitive Pay

📋 FMCSA Compliant

🛣️ OTR / Regional Routes

🤝 Family Culture

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Personal Information

First Name *

Last Name *

Phone *

Email *

City *

State *

ZIP

Date of Birth

Available Start Date *

CDL & Licensing

CDL Class *

Issuing State *

Years Holding CDL *

CDL Expiration *

Medical Card Expiration *

Endorsements (check all that apply)

Driving Experience

Run Type *

Career Miles (approx)

Pay Expectation

Employment History

FMCSA §391.21 requires 3 years of employment history. List most recent first.

Employer #1 (Most Recent)

Company Name

Phone

Job Title

From

Reason for Leaving

Employer #2

Company Name

Phone

Job Title

From

Reason for Leaving

Employer #3

Company Name

Phone

Job Title

From

Reason for Leaving

Safety Record

All questions required. Answer honestly — falsification is grounds for immediate termination.

Have you ever been convicted of DUI/DWI or any drug/alcohol-related driving offense?

Has your license ever been suspended, revoked, or denied in any state?

Have you been involved in any at-fault accidents in the past 3 years?

Have you received any moving violations in the past 3 years?

Professional References

Please provide 2 professional references (not family members).

Reference 1 – Name *

Phone *

Relationship

Reference 2 – Name *

Phone *

Relationship

About You

Why do you want to drive for JAX Express? *

Additional Notes or Qualifications

How did you hear about us?

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Certification & Signature

I certify that the information provided in this application is true, complete, and accurate to the best of my knowledge. I understand that falsification of this application is grounds for refusal of employment or immediate termination. I authorize JAX Express Logistics LLC to contact previous employers and references listed above. I understand that this application is not a contract of employment.

Electronic Signature *

Date *

Your application is stored securely in our system. A notification email is sent to our hiring team. We do not collect SSN or full driver's license numbers at this stage.

JAXEXPRESS

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Application Submitted!

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