Georgia Truck Driving School
Your Source for Top-Quality Truck Driving Instruction
Not sure where to begin? Then give us a call today! (866) 319-1992
Name:*
DOB:*
Phone:*
Email:*
Address:*
City:*
State:*
Zip:*
Drivers License # :*
State Issued:*
Expiration Date:*
Personal Information
Social Security # :*
Driving History
Have you ever had your driver's license revoked?
If yes give the year and reason:
In the last 5 years, how many tickets have you received?
Ticket #1 Year and reason:
Ticket #2 Year and reason:
Ticket #3 Year and reason:
In the last five years, how many accidents have you had?
Have you ever been convicted of a felony or misdemeanor?
Have you ever been convicted of a DUI?
If yes, give the year and reason:
If yes, please explain:
The essential funchtion of a road driver is:
Must be available for work 24 hours per day, 7 days per week, working 70 hours in 8 days (drive a continuous 10 hours, or as Section 395 allows).
Be able to load or unload cargo up to 75 pounds per item.
Be able to: dolling trailer, sliding tandems, pulling king pin and hood for pre-trip inspections and fueling the truck.
Can you perform the job functions just described?
Current Medications:
Have you ever filed a workers' comp claim?
If yes, please explain:
Employment
Current/Last Employer:
Dates of Employment From: To:
Complete address:
Phone:
Job Title:
Reason for leaving:
Previous Employer:
Dates of Employment From: To:
Complete address:
Phone:
Job Title:
Reason for leaving:
By clicking submit, I certify that to the best of my knowledge the above information is true.
Copyright 2012: Great Southern Driving Academy, LLC | Truck Driving School in Georgia. All Rights Reserved.
Great Southern Driving Academy, LLC
P.O Box 99
Tunnel Hill, GA 30755-9325
Education Director: Bryan Riddle
Admissions Director: Catherine Riddle
Phone: (706) 673-1992
Fax: (706) 673-6876
Toll Free: (866) 319-1992
info@gsdacademy.net
CDL Application
