Welcome to the New Mercer Site!

We've been doing some work here, have a look around!

Phone: 253-250-0860
dispatch@mercerlogistics.com

Owner Operator Driver application

    Instructions to applicant: Please answer all questions. If the answer to any question is "no" or "none", do not leave it blank, write "no" or "none" in the space.

    First Name
    Last Name

        ext.

          ext.

            ext.

                              Current and Three Years Previous Addresses

                                Street
                                Apt# / PO Box
                                City
                                StatePostal Code

                                  Street
                                  Apt# / PO Box
                                  City
                                  StatePostal Code

                                    Street
                                    Apt# / PO Box
                                    City
                                    StatePostal Code

                                      Street
                                      Apt# / PO Box
                                      City
                                      StatePostal Code

                                        Education

                                        Please circle the highest grade completed

                                                Work History

                                                Give a complete work history for the past THREE years, including any unemployment or self-employment and provide W-2 or 1099, for any out of business companies. All commercial driving experience to the past TEN years. Begin with the most recent job.

                                                  Last Employment

                                                          Street
                                                          Apt# / PO Box
                                                          City
                                                          StatePostal Code

                                                            ext.

                                                                      Previous Employment 1

                                                                              Street
                                                                              Apt# / PO Box
                                                                              City
                                                                              StatePostal Code

                                                                                ext.

                                                                                          Previous Employment 2

                                                                                                  Street
                                                                                                  Apt# / PO Box
                                                                                                  City
                                                                                                  StatePostal Code

                                                                                                    ext.

                                                                                                              Previous Employment 3

                                                                                                                      Street
                                                                                                                      Apt# / PO Box
                                                                                                                      City
                                                                                                                      StatePostal Code

                                                                                                                        ext.

                                                                                                                                  Previous Employment 4

                                                                                                                                          Street
                                                                                                                                          Apt# / PO Box
                                                                                                                                          City
                                                                                                                                          StatePostal Code

                                                                                                                                            ext.

                                                                                                                                                      Previous Employment 5

                                                                                                                                                              Street
                                                                                                                                                              Apt# / PO Box
                                                                                                                                                              City
                                                                                                                                                              StatePostal Code

                                                                                                                                                                ext.

                                                                                                                                                                          Driving Experience

                                                                                                                                                                                                        Accident Record for the past three years

                                                                                                                                                                                                        Upload additional documents if more space is needed

                                                                                                                                                                                                            (head on, rear-end, upset, etc.)

                                                                                                                                                                                                                        (head on, rear-end, upset, etc.)

                                                                                                                                                                                                                                    (head on, rear-end, upset, etc.)

                                                                                                                                                                                                                                                (head on, rear-end, upset, etc.)

                                                                                                                                                                                                                                                          Traffic Convicitions and Forfeitures for the last three years

                                                                                                                                                                                                                                                          All convictions other than parking citations, upload additional documents if more space is needed

                                                                                                                                                                                                                                                                                                    Driver's License

                                                                                                                                                                                                                                                                                                    List each driver's license held in the past three years

                                                                                                                                                                                                                                                                                                                                              Driver Questionnaire

                                                                                                                                                                                                                                                                                                                                                          Personal References

                                                                                                                                                                                                                                                                                                                                                          List three persons for references, other than family members who have knowledge of your safety habits

                                                                                                                                                                                                                                                                                                                                                            First Name
                                                                                                                                                                                                                                                                                                                                                            Last Name

                                                                                                                                                                                                                                                                                                                                                              ext.

                                                                                                                                                                                                                                                                                                                                                                First Name
                                                                                                                                                                                                                                                                                                                                                                Last Name

                                                                                                                                                                                                                                                                                                                                                                  ext.

                                                                                                                                                                                                                                                                                                                                                                    First Name
                                                                                                                                                                                                                                                                                                                                                                    Last Name

                                                                                                                                                                                                                                                                                                                                                                      ext.

                                                                                                                                                                                                                                                                                                                                                                        To be Read and Signed by Applicant

                                                                                                                                                                                                                                                                                                                                                                        It is agreed and understood that any misrepresentation given on this application for qualification shall be considered an act of dishonesty.

                                                                                                                                                                                                                                                                                                                                                                          I give the motor carrier and its agents or representatives the right to investigate all references and to secure additional information about my work history. I herby release from all liability for damages the motor carrier and its agents or representatives for seeking such information and all other persons, corporations or organizations for furnishing such information.

                                                                                                                                                                                                                                                                                                                                                                            I agree to furnish such additional information and complete such examinations as may be required to complete my qualifications file.

                                                                                                                                                                                                                                                                                                                                                                              It is agreed and understood that this application for qualification in no way obligates the motor carrier to contract with my company.

                                                                                                                                                                                                                                                                                                                                                                                This certifies the 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.

                                                                                                                                                                                                                                                                                                                                                                                  First Name
                                                                                                                                                                                                                                                                                                                                                                                  Last Name

                                                                                                                                                                                                                                                                                                                                                                                      Using mouse or finger sign below, click "clear" to retry

                                                                                                                                                                                                                                                                                                                                                                                      clear

                                                                                                                                                                                                                                                                                                                                                                                        Browse to add files, click "Add another File" to upload additional documents

                                                                                                                                                                                                                                                                                                                                                                                        Add Another File

                                                                                                                                                                                                                                                                                                                                                                                          Loading...

                                                                                                                                                                                                                                                                                                                                                                                          Loading...