Employment Application

800 Morris Street, Fond du Lac, WI 54935 

920-923-7920

We Sincerely appreciate your interest in employment with DuFrane Moving and Storage, Inc. and assure you that we are interested in your qualifications. To give us a clear understanding of your background and work history, we ask that you fill in all 'information requested. This greatly helps us in our screening process and enables us to place candidates in positions that best meet their qualifications and our needs.


A resume does not replace the requirement to have this form completed. However, it may be included. Incomplete applications will not be considered. Applications are active for 90 days.


If you need any assistance in the completion of this form or in our application process, please ask and we will be glad to help you.

Employment Application

DuFrane Moving and Storage

An Equal Opportunity Employer

COMPLETE IN FULL OR IT WILL NOT BE CONSIDERED. 

APPLICANT INFORMATION

PREVIOUS THREE YEARS RESIDENCY

LICENSE INFORMATION

No person who operates a commercial motor vehicle shall at any time have more than one driver’s license (49 CFR 383.21). I certify that I do not have more than one motor vehicle license, the information for which is listed below. Include all licenses held for the past 3 years; attach additional sheets if needed.

PREVOIUSLY HELD LICENSES

DRIVING EXPERIENCE

ACCIDENT RECORD FOR THE PAST 3 YEARS

TRAFFIC CONVICTIONS AND FORFEITURES FOR THE PAST 3 YEARS (OTHER THAN PARKING VIOLATIONS)

EMPLOYMENT HISTORY

The Federal Motor Carrier Safety Regulations (49 CFR 391.21) require that all applicants wishing to drive a commercial vehicle list all employment for the last three (3) years. In addition, if you have driven a commercial vehicle previously, you must provide employment history for an additionalseven (7) years (for a total of ten (10) years). Any gaps in employment in excess of one (1) month must be explained.


Start with the last or current position, including any military experience, and work backwards(attach separate sheets if necessary).

You are required to list the complete mailing address, including street number, city, state,zip; and complete all other information.

CURRENT (MOST RECENT) EMPLOYER

SECOND (MOST RECENT) EMPLOYER

THIRD (MOST RECENT) EMPLOYER

EDUCATION

OTHER QUALIFICATIONS

TO BE READ AND SIGNED BY APPLICANT

I authorize you to make investigations (including contacting current and prior, employers) into my personal, employment, financial, medical history, and other related matters as may be necessary in arriving at an employment decision. I hereby  release employers, schools, health care providers, and other persons from all liability in responding to inquiries and releasing information in connection with my application.


In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I also understand that I am required to abide by all rules and regulations of the Company.


I understand that the information I provide regarding my current and/or prior 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. I understand that I have the right to:

  • Review information provided by current/previous employers;
  • Have errors in the information corrected by previous employers, and for those previous employers to resend the corrected information to the prospective employer; and
  • 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.

This certifies that I completed this application, and that all entries on it and information in it are true and complete to the best of my knowledge. Note: A motor carrier may require an applicant to provide more information than that required by the Federal Motor Carrier Safety Regulations.

736 Morris Street, Fond du Lac, WI 54935

APPLICANT ACKNOWLEDGEMENT

(Please read carefully and sign) 

  • I certify that all statements and information contained in this application were made by me and are true, correct and complete to the best of my knowledge and belief. I understand that any misrepresentation or omission of any kind may result in denial of employment or be cause for subsequent dismissal if I am hired.
  • I authorize Dufrane to investigate my responses on this application and to contact all former employers, government agencies or any individuals familiar with me and my employment background or driving record for purposes of verifying any information I have provided or obtaining any information, whether favorable or unfavorable, about me or my employment. voluntarily and knowingly fully release and hold harmless any person or organization that provides information pertaining to me and/or my employment as conditioned by law.
  • I understand that upon receiving a job offer, a physical examination and/or drug screening may be required. (Note: If this is a job requirement, you will be notified of this requirement following an offer of employment. Such requirement would have to be successfully completed as a condition of employment.)
  • I understand that if I am hired, I will be required to provide proof of identity and legal work authorization.
  • I understand that this application for employment shall be considered active for a period of time not to exceed 90 days. If I wish to be considered for employment beyond this time period, it will be necessary for me to complete a new application form.     
  • Regardless of whether or not I become employed by Dufrane, I recognize that this application process and any offer of employment shall not be considered as a contract of employment. I understand that the terms and conditions of my employment may be changed with or without cause or prior notice at any time. I understand that employment with Dufrane is on an "At Will" basis and that either Dufrane or I can terminate my employment with or without cause and/or notice, at any time, unless I specifically have been or I issued a written employment contract. That no person other than the president has the authority to offer any agreement regarding employment or employment contract. That unless such agreement/contract has been executed in writing to me, by the President, my employment with DuFrane is "At Will" and I in no way bind Dufrane to a contractual agreement regarding permanency of employment.
  • I authorize Dufrane to deduct all outstanding personal expenses charged to Dufrane and unearned pay benefits from my paycheck.

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