Job Application Job Application Download and complete a print version of the Job Application or submit an electronic version by filling out the form below. Download Print Application Step 1 of 4 25% Driver's Application for EmploymentSouthwest Distributors, Inc. is an Equal Opportunity Employer. We consider all applicants, for all positions, without regard to race, color, religion, gender, national origin, age, marital or veteran status, the presence of a non-job related medical condition or handicap, or any other legally protected status.Date of applicationMonthMonth123456789101112DayDay12345678910111213141516171819202122232425262728293031YearYear20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Name First Last PhoneAdditional phone numberPlease list your current address and all addresses for three years preceding date of application. Address Actions Edit Delete There are no Addresses. Add Address Maximum number of addresses reached. Are you currently employed?(Required) Yes No How long since your last employment?(Required)Employment EligibilityAre you willing to work the following?Regular hours(Required) Yes No Overtime(Required) Yes No Weekends(Required) Yes No On what date would you be able to start working?(Required)MonthMonth123456789101112DayDay12345678910111213141516171819202122232425262728293031YearYear20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Can you life 50 pounds?(Required) Yes No Are you now, or do you expect to be engaged in any other business or employments?(Required) Yes No Do you know anyone who works for this company? Yes No What is their name? First Last Has someone referred you to this company? Yes No Who referred you to this company? First Last If Southwest Distributors Inc. employs you, can you produce verification of your legal right to work in the United States?(Required) Yes No Have you been convicted of a felony within the last 10 years?(Required) Yes No ExplainExplain Skill Questions1. A customer ordered 20 cases of product at $16.15 per case with a $1.50 per case discount. What is the total charge for the product, including 7% sales tax?(Required)2. The salesman sent 100 cases of product at $10.50 per case plus 7% sales tax, but the store manager only ordered 75 cases. How much of a credit would you have to give the store manager on that invoice for the product he did not want?(Required)3. You have made a delivery to a cash account and the invoice totaled $407.23. How much change would you return if the store manager gave you five $100 dollar bills?(Required)EducationLast grade completed(Required)Last elementary schoolLast high schoolLast high school address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State Did you graduate high school?(Required) Yes No Junior college or vocational schoolJunior college or vocational school address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State Field of studyDid you graduate from junior or vocational college?(Required) Yes No College or universityCollege or university address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State Field of studyDid You graduate college?(Required) Yes No Graduate schoolGraduate school address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State Field of studyDid you graduate from graduate school?(Required) Yes No List all degrees attainedAre you presently enrolled in or plan to enroll in school?(Required) Yes No Are you interested in furthering your education in the future?(Required) Yes No Where and when?What subjects did you excel at in school?Additional educational informationHave you served in the U.S. Military?(Required) Yes No Did your military experience and training provide you with skills you could put to use in this job? Yes No ExplainPlease summarize special skills and qualifications acquired from past employment or other experiences.(Required)List the equipment you can operate (be specific).(Required)Have you ever operated a computer?(Required) Yes No Indicate the level of proficiency in each application below by circling only one choice that best describes your skill level in each area.
Windows(Required) Never used Rarely used Occasionally used Skilled Excel(Required) Never used Rarely used Occasionally used Skilled Microsoft Office(Required) Never used Rarely used Occasionally used Skilled PowerPoint(Required) Never used Rarely used Occasionally used Skilled Employment ExperienceStart with your present or last job. Include military service assignments and volunteer activities. Please exclude any organization names that indicate race, color, religion, gender, national origin, handicap or other protected status. Include all employment for the past 10 yrs. and use back of page if necessary. Employer Phone Address Start Wage Final Wage Supervisor Duties Exit Details Regulations Designation & Testing Actions Edit Delete There are no Entries. Add Entry Maximum number of entries reached. Professional ReferencesList at least three professional references. Name Phone Company Mailing Address Relationship to You Actions Edit Delete There are no References. Add Reference Maximum number of references reached. Driving and License InformationMotor Vehicle AccidentsPlease list all motor vehicle accidents in which you were involved in during the previous three (3) years. Accident Description Actions Edit Delete There are no Accidents. Add Accident Maximum number of accidents reached. Do you currently hold a valid drivers license?(Required) Yes No Drivers license number(Required)Issuing state(Required) AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State Expiration date(Required)MonthMonth123456789101112DayDay12345678910111213141516171819202122232425262728293031YearYear20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Check the class(es) of Commercial Drivers Licenses you currently hold.(Required) A B C D Have you held a drivers license in another sate within the past three (3) years?(Required) Yes No Other Drivers License Information State License Number Actions Edit Delete There are no Licenses. Add License Maximum number of licenses reached. Have you ever had any moving traffic convictions?(Required) Yes No Please provide details about your moving traffic convictions.Have you ever been denied the privilege of a license or permit to drive a motor vehicle or Commercial motor vehicle?(Required) Yes No ExplainHas your privilege, license, or permit ever been suspended or revoked?(Required) Yes No Explain Application AgreementPLEASE READ THE FOLLOWiNG STATEMENT CAREFULLY BEFORE SIGNING I authorize investigation of all statements contained in this application. I understand that falsification, omission, or misrepresentation of facts called for may result in termination or the removal of my application from consideration. I authorize Southwest Distributors, Inc. to obtain information about my experience with former employers. I authorize those parties to provide information about my experience and I release those parties from any liability arising there from. I understand that information I provide regarding current and/or previous employers may be used, and those employer(s) will be contacted for the purpose of investigating my safety performance history as required by 49 CFR 391.23(d). I understand that I have the right to 1) review information provided by previous employers; 2) have errors in the information corrected by previous employers and for those previous employers to re-send the corrected information to the prospective employer; 3) Have a rebuttal statement attached to the alleged erroneous information, if the previous employer(s) and I cannot agree on the accuracy of the information. I understand that nothing set forth in this employment application or in the granting of an interview is intended to create an employment contract between Southwest Distributors, Inc. and myself for employment. If Southwest Distributors, Inc. employs me; I agree to conform to the rules and regulations of Southwest Distributors, Inc. I also agree and understand that wages, hours and working conditions are subject to change by Southwest Distributors, Inc. at any time, with or without notice. I understand that all employment at Southwest Distributors, Inc. is on an at-will basis. That means that Southwest Distributors or myself can terminate the employment relationship at any time, with or without notice, and with or without cause. I understand that only the president of Southwest Distributors, Inc. has the authority to enter into any agreement contrary to the foregoing and then only in writing. I understand that a physical examination and drug and alcohol-screening test may be required after a conditional offer of employment is extended. I understand that refusal to take a physical examination, including drug and alcohol screening test, refusal to submit a blood or urine sample for testing, or refusal to sign an authorization form may result in disqualification for employment. I authorize any physician or hospital to release any information, which may be necessary to determine my ability to perform the duties of a job for which I am being considered. I certify that I have read and that I understand the foregoing, and acknowledge that no offer or promise of employment has been made. I also certify that to the best of my knowledge, the information contained herein is true, correct, and complete. DateMonthMonth123456789101112DayDay12345678910111213141516171819202122232425262728293031YearYear20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920SignatureSouthwest Distributors, Inc. considers applications for only a sixty, (60) day period. If you wish to be considered after sixty, (60) days, please reapply.CAPTCHA