P.O. Box 5417 McAllen, Tx 78502 Toll Free: (877) 843-1001 Fax :(956) 843-1009 info@ProgisticCarriers.com
General Informartion
Yes No
Yes No
Equipment Experience
Dry Van Reefer Tanker
Flatbed Auto Haul Military
Small Pkg Delivery Straight Truck Moving Van
Livestock Other None
Diesel Mechanic Experience
Detroit Cummins Cat All engine types
Misc Important Info
Willing to Re-Locate? *
Yes No
How many On/Off Duty accidents in last 3 Years? * Enter Number 0, 1, 2, 3 etc.
Any DUI/DWI's in last 5 years? *
Yes No
Ever tested positive on a drug screen? *
Yes No
Ever had a felony in your life time? *
Yes No
Job Code
Employment History 
Most Recent Employer Company Name 
Most Recent Employer's (Area Code) and Phone
Who can we speak with at Most Recent Employer?
Most Recent Employer Hire and End Date
Hire Date mo/yr End Date mo/yr Still there? Yes
Previous Employer Company Name
Previous Employer (Area Code) and Phone.
Who can we speak with at your Previous Employer?.
Previous Employer Hire Date
Hire Date mo/yr End Date mo/yr
Please Read Authorization Statement  
Did you read, understand and agree to Authorization Statement? * Yes