Driver Application – Rx Express

Drive with Rx Express

Join Rx Express as a professional driver and be a vital part of our mission to safely and efficiently deliver critical pharmaceuticals. We offer competitive pay, flexible schedules, and the opportunity to work with a dedicated team. Start your rewarding driving career with us today!

APPLICANT INFORMATION
NAME*
First Last
EMAIL*
PHONE*
ADDRESS
City State / Province / Region ZIP / Postal Code
DATE OF BIRTH
MM slash DD slash YYYY
POSITION APPLIED FOR
Do you have legal right to work in the United States?
- Yes
- No
LICENSE INFORMATION
STATE
LICENSE #
TYPE/CLASS
ENDORSEMENTS
EXPIRATION DATE
DRIVING EXPERIENCE
CLASS OF EQUIPMENT
DATE FROM
MM slash DD slash YYYY
DATE TO
MM slash DD slash YYYY
APPROX # OF MILES (TOTAL)
ACCIDENT RECORD FOR THE PAST 3 YEARS
DATES (List most recent first)
MM slash DD slash YYYY
NATURE OF ACCIDENT (Head-on, rear-end, upset, etc.)
# FATALITIES
# INJURIES
CHEMICAL SPILLS (Y/N)
TRAFFIC CONVICTIONS AND FORFEITURES FOR THE PAST 3 YEARS (OTHER THAN PARKING VIOLATIONS)
DATE CONVICTED
MM slash DD slash YYYY
VIOLATION
STATE OF VIOLATION
PENALTY (Forfeited bond, collateral and/or points)
Have you ever been denied a license, permit, or privilege to operate a motor vehicle? If yes, explain
Has any license, permit, or privilege ever been suspended or revoked? If yes, explain
EDUCATION
SCHOOL
NAME & LOCATION
COURSE OF STUDY
YEARS COMPLETED
OTHER QUALIFICATIONS
Please list any other qualifications that you have and which you believe should be considered.

Drive with Rx Express

APPLICANT INFORMATION

LICENSE INFORMATION

DRIVING EXPERIENCE

ACCIDENT RECORD FOR THE PAST 3 YEARS

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

EDUCATION