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TRUCK DRIVING PROGRAM APPLICATION

Truck Driving School Application

First Name

Last Name

Phone

Date of birth

Full mailing address ( City, State, Zip Code)

How did you hear about us?

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What will be your source of funding for this course? (ex: Loan, personal, etc.)

Can you read, write, and speak English?

Yes

Are you over 21 years of age?

Yes

Are you a citizen of the United States?

Yes

Do you have a current and valid California Drivers License?

Yes

Have you ever gotten a DWI or DUI?

Yes

If you answered yes to the previous question, what was the date you received a DWI/DUI?

Have you ever been arrested for any narcotics charges?

Yes

Have you ever held a commercial license?

Yes

Do you have any felonies or midemeanors?

Yes

Do you wear any hearing apparatus?

Yes

Are you currently on any medications?

Yes

Do you have any eyesight impairments or colorblindness?

Yes

Have you physically lost any part of your body?

Yes

Are you presently employed?

Yes

Please give an explanation to each question you answered "Yes" to the previous question

Is there a reason you cannot be away from home for extended periods (3-4 weeks)?

Yes

Have you ever been on probation or parole?

Yes

Please give an explanation to each question you answered "Yes" to the pervious question

Today's Date:

SUBMIT

Contact Us

530-223-5693

8530 Commercial Way, Redding, CA 96002

9AM - 5PM PST Admission Hours

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Nationally Accredited By COE AND LICENSED BY STATE OF CA BPPE

8530 Commercial Way, Redding, CA 96002

Monday–Friday 8:00 AM-5:00 PM

530-223-5693