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Driver Experience – Supplementary Application Form

If you've applied to work as a driver, please fill out the form below after you've submitted your primary application form.

  • MM slash DD slash YYYY
  • Driver Licenses

    Please list all driver licenses you have had in the past three (3) years.
    • Drivers License #1

    • Drivers License #2

    • Drivers License #3

  • If you have had more driver licenses than 3 in the past three years, please list all further driver licenses here. Include: State, License Number, Class, Endorsement, and Expiration Dates for all licenses.
    • Driving Experience

    • (Straight Truck, Tractor Trailer, 10 Wheeler, Other)
    • Please include the dates you started and stopped working with each type of equipment.
  • Please list the date, city/town & state, type of accident, injuries, and fatalities for each accident.
  • Please list the date, location, charge/offense, and penalty for each conviction.
  • Driver Applicant's Certification & Agreement.

  • By filling my name in the field below and/or submitting this information electronically, I certify that answers given herein are true and complete to the best of my knowledge. I authorize investigation of all statements contained in this application supplement as may be necessary in arriving at an employment decision. I authorize Andrews Construction Co., Inc. and/or its agent to obtain the necessary motor vehicle records. I understand in compliance with § 40.25(g) and § 391.23, Andrews Construction Co., Inc. shall request information from prior employers with regards to my services, accident history, drug and alcohol history and conduct while in their employ. In the event of employment, I understand that false or misleading information given in my applications or interview (s) may result in discharge. I further understand and agree that if hired my employment is “at will” for no definite period and may regardless of the date of payment of my wages or salary be terminated at any time without any prior notice, for any reason, and that it in no way is to be construed as a contract of employment.

  • This constitutes a signature.
  • MM slash DD slash YYYY
  • Notice to New Hampshire Applicants – for driving records, the release is to be kept for no more than two years from the date of signature. See N.H. Stat. Ann § RSA 360:14V9(c)(2)(D).

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Contact Us

Mailing Address:
P.O. Box 720
Campton, NH 03223

Physical Address:
392 NH Route 49
Campton, NH 03223

Phone: 603.726.7623
Fax: 603.726.7313
Email: info@andrewsconst.com

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