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April 16, 2013

Dear Applicant,

Thank you for your interest in either an Owner/Operator or Company Driver position at Select 1 Transport, Inc. We work with some of the most recognizable automakers and brands in the world and operate within 49 states as well as throughout Canada.

Please complete and submit this application packet. It is important that you complete all required fields within this application that apply to you. The application is to be completed utilizing Abode Reader. Please note we will not accept applications that are handwritten. The only fields within this application that may be filled out by hand are those fields requesting your signature.

Once you have entered all of the information requested, you should save a version for your records, then print out a copy to sign and submit for consideration. Note that applications without signatures will not be accepted.

Completed applications may either be faxed to 734-946-7915 or mailed to us at:

Select 1 Transport, Inc. Attn: Trucking Careers 25005 Brest Rd. Taylor, MI 48180

We want to thank you once again for your interest in Select 1 Transport. We wish you the best and hope to speak with you soon. If you have any questions regarding the position you are applying for, please contact me at 1-888-710-9700 ext. 7.

Sincerely,

Andrea Mousseau Safety & Compliance/HR Manager [email protected]

, (Rev. 04/16/2013)

IMPORTANT NOTICE: REGARDING BACKGROUND INVESTIGATION AND REPORTS

In connection with my application for employment with Select 1 Transport, Inc., (“Prospective Employer”), Select 1, its employees, agents or contractors may obtain one or more reports regarding my driving and safety history from the Federal Motor Carrier Safety Administration (FMCSA) in addition to using other background services regarding fitness for hire.

When the application for employment is submitted in person, if Select 1 uses any information it obtains from any service, including the FMCSA, in a decision to not hire me or make any other adverse employment decision regarding me, Select 1 will provide me with a copy of the report upon which its decision was based and a written summary of my rights under the Fair Credit Reporting Act before taking any final adverse action. If any final adverse action is taken against me based upon my driving history or safety report, Select 1 will notify me that the action was taken and that the action was based in part or in whole on this report.

When the application for employment is submitted by mail, telephone, computer or other similar means, if Select 1 uses any information it obtains from FMCSA in a decision to not hire me or to make any other adverse employment decision, Select 1 will provide me within three (3) business days of taking adverse action oral, written or electronic notification: that the adverse action was taken based in whole or in part on information obtained from FMCSA; the name, address and toll free number of FMCSA; that the FMCSA did not make the decision to take the adverse action and is unable to provide me the specific reasons why the adverse action was taken; and that I may, upon providing proper identification, request a free copy of the report and my dispute with the FMCSA the accuracy or completeness of any information or report. If I request a copy of a driver report from Select 1 who procured the report, then, within three (3) business days of receiving my request, together with proper identification, Select 1 must send or provide me a copy of my report and a summary of my rights under the Fair Credit Reporting Act.

Select 1 cannot obtain background reports unless I consent in writing.

If you agree that Select 1 may obtain background information and/or reports, please read the following and sign below: I authorize Select 1 to access the FMCSA Pre-Employment Screening Program (PSP) system to seek information regarding my commercial driving safety record and information regarding my safety inspection history in addition to other services to obtain my personal history and background.

, (Rev. 04/16/2013)

I understand that I am consenting to the release of personal information including, but not limited to personal

data, driver’s license and motor vehicle records for the previous five (5) years as well as inspection history from

the previous three (3) years.

I understand and acknowledge that this release of information may assist Select 1 to make a determination

regarding my suitability as a driver.

I further understand that neither Select 1 nor any private or public agency, such as the FMCSA, or contractors

supplying the information, has the capability to correct any data that appears to be incorrect, other than as

follows:

I further understand that neither Select 1 nor the FMCSA contractor supplying the crash and safety information

has the capability to correct any safety data that appears to be incorrect. I understand I may challenge the

accuracy of the data by submitting a request to https://dataqs.fmcsa.dot.gov. If I am challenging crash or

inspection information reported by a State, FMSCA cannot change or correct this data. I understand my request

will be forwarded by the DataQs system to the appropriate State for adjudication.

Please note: Any crash or inspection in which you were involved will display on your PSP report. Since the PSP

report does not report, or assign, or imply fault, it will include all Commercial Motor Vehicle (CMV) crashes

where you were a driver or co-driver and where those crashes were reported to the FMCSA, regardless of fault.

Similarly, all inspections, with or without violations, appear on the PSP report. State citations associated with

FMCSR violations that have been adjudicated by a court of law will also appear and remain, on a PSP report.

I have read this Notice Regarding Background Investigation provided to me by Select 1 and I understand that if I

sign this consent form, Select 1 will obtain my personal information including, but not limited to personal data,

driver’s license and motor vehicle records.

I hereby authorize Select 1 and its authorized agents to obtain the information described above.

SIGNATURE DATE

TYPE NAME

, (Rev. 04/16/2013)

DRIVER’S APPLICATION FOR EMPLOYMENT

APPLICANT NAME (TYPE) __________________________ DATE OF APPLICATION ____________________________

COMPANY ___________________________________________________________________________________________

ADDRESS ___________________________________________________________________________________________

CITY _____________________________________________________ STATE ___________ ZIP ___________________

I AM APPLYING FOR: COMPANY DRIVER OWNER OPERATOR

BEFORE FILLING OUT THIS APPLICATION PLEASE ANSWER THESE FOUR QUESTIONS:

DO YOU HAVE A VALID CDL-A? YES NO

HAVE YOU RECEIVED ANY DISQUALIFYING MOVING VIOLATIONS (DUI, RECKLESS OR CARELESS DRIVING, SPEEDING 15+MPH, FOLLOWING TOO CLOSE)? YES NO

DO YOU HAVE THREE OR MORE YEARS OVER THE ROAD EXPERIENCE? YES NO

CAN YOU TRAVEL INTO CANADA? YES NO

In compliance with Federal and State equal employment opportunity laws, qualified applicants are considered for all positions without regard to race, color, religion, sex, national orgin, age, marital status, veteran status, non-job related disability, or any other protected group status.

FOR COMPANY USE

PROCESS RECORD

APPLICANT HIRED __________________________________ REJECTED __________________________________

DATE EMPLOYED ___________________________________ POINT EMPLOYED ____________________________

DEPARTMENT ______________________________________ CLASSIFICATION _____________________________ (IF REJECTED, SUMMARY REPORT OF REASONS SHOULD BE PLACED IN FILE)

SIGNATURE OF INTERVIEWING OFFICER _____________________________________________________________

TERMINATION OF EMPLOYMENT

DATE TERMINATED __________________________ DEPARTMENT RELEASED FROM _______________________

DISMISSED _____________________________ VOLUNTARILY QUIT _______ OTHER _______________________

TERMINATION REPORT PLACED IN FILE _____________ SUPERVISOR ___________________________________

SELECT 1 TRANSPORT, INC.

25005 BREST RD.

TAYLOR MI 48180

, (Rev. 04/16/2013)

APPLICATION TO COMPLETE(ANSWER ALL QUESTIONS – PLEASE TYPE)

POSITION(S) APPLIED FOR: COMPANY DRIVER OWNER/OPERATOR

NAME ______________________________________________________________________________________________LAST FIRST MIDDLE

SOCIAL SECURITY NO. ____________________________________ EMAIL _____________________________________

LIST YOUR ADDRESSES OF RESIDENCY FOR THE PAST 3 YEARS.

CURRENT ADDRESS

____________________________________________________________________________________________________STREET

____________________________________________________________________________________________________CITY STATE ZIP

____________________________________________________________________________________________________HOME PHONE CELL PHONE HOW LONG (YR./MO.)

PREVIOUS ADDRESSES

____________________________________________________________________________________________________STREET CITY STATE ZIP CODE HOW LONG (YR./MO.)



DO YOU HAVE THE LEGAL RIGHT TO WORK FOR THIS COMPANY IN THE UNITED STATES? YES NO

DATE OF BIRTH ________________________________(REQUIRED FOR COMMERCIAL DRIVERS)

HAVE YOU WORKED FOR THE COMPANY BEFORE? YES NO WHERE? _______________________________

DATES: FROM ______________ TO ______________ RATE OF PAY ____________ POSITION ___________________

REASON FOR LEAVING RESIGNED LAY-OFF TERMINATED

ARE YOU NOW EMPLOYED? YES NO

IF NOT, HOW LONG SINCE LEAVING LAST EMPLOYMENT? __________________________________________________

WHO REFERRED YOU? _______________________________ RATE OF PAY EXPECTED ________________________

HAVE YOU EVER BEEN BONDED? YES NO(ANSWER ONLY IF A JOB REQUIREMENT)

/ /

, (Rev. 04/16/2013)

HAVE YOU EVER BEEN CONVICTED OF A FELONY? YES NO

IF YES, WHAT FELONY WERE YOU CONVICTED OF? CONVICTION OF A CRIME IS NOT AN AUTOMATIC BAR TO EMPLOYMENT-ALL CIRCUMSTANCES WILL BE CONSIDERED. _______________________________________________

IS THERE ANY REASON YOU MIGHT BE UNABLE TO PERFORM THE FUNCTIONS OF THE JOB FOR WHICH YOU HAVE APPLIED YES NO

IF YES, EXPLAIN IF YOU WISH.

HOW DID YOU HEAR ABOUT THIS POSITION?

EMPLOYMENT HISTORYAll driver applicants to drive in interstate commerce must provide the following information on all employers during the preceding 3 years. List complete mailing address, street number, city, state and zip code.

Applicants to drive a commercial motor vehicle* in intrastate or interstate commerce shall also provide an additional 7 years’ information on those employers for whom the applicant operated such vehicle. (Note: List employers in reverse order starting with the most recent. Add another sheet as necessary.)

EMPLOYER DATE

NAMEFROM

MO. YR.TO

MO. YR.

ADDRESSPOSITION HELD

CITY STATE ZIPSALARY/WAGE

CONTACT PERSON PHONE NUMBERREASON FOR LEAVING

WERE SUBJECT TO THE FMCSRs† WHILE EMPLOYED? YES NOWAS YOUR JOB DESIGNATED AS A SAFETY-SENSITIVE FUNCTION IN ANY DOT-REGULATED MODE SUBJECT TO THE DRUG AND ALCOHOL TESTING REQUIREMENTS OF 49 CFR PART 40? YES NO

, (Rev. 04/16/2013)

EMPLOYMENT HISTORY (continued)EMPLOYER DATE

NAMEFROM

MO. YR.TO

MO. YR.





EMPLOYER DATE

NAMEFROM

MO. YR.TO

MO. YR.





EMPLOYER DATE

NAMEFROM

MO. YR.TO

MO. YR.





, (Rev. 04/16/2013)

EMPLOYMENT HISTORY (continued)EMPLOYER DATE

NAMEFROM

MO. YR.TO

MO. YR.





EMPLOYER DATE

NAMEFROM

MO. YR.TO

MO. YR.





* Includes vehicles having a GVWR of 26,001 lbs. or more, vehicles designed to transport 16 or more passengers (includingthe driver), or any size vehicle used to transport hazardous materials in a quantity requiring placarding.

† The Federal Motor Carrier Safety Regulations (FMCSRs) apply to anyone operating a motor vehicle on a highway in interstate commerce to transport passengers or properly when the vehicle: (1) weighs or has a GVWR of 10,0001 pounds or more, (2) is designed or used to transport more than 8 passengers (including the driver), OR (3) is of any size and is used to transport hazardous materials in a quantity requring placarding.

ACCIDENT RECORD FOR THE PAST 3 YEARS OR MORE (ATTACH SHEET IF MORE SPACE IS NEEDED) IF NONE, TYPE NONE

DATES NATURE OF ACCIDENT (HEAD-ON, REAR-END, UPSET, ETC.) FATALITIES INJURIES VEHICLES

TOWED-AWAY

LAST ACCIDENT YES NO YES NO YES NO

NEXT PREVIOUS YES NO YES NO YES NO

NEXT PREVIOUS YES NO YES NO YES NO

TRAFFIC CONVICTIONS FORFEITURES FOR THE PAST 3 YEARS (OTHER THAN PARKING VIOLATIONS) IF NONE, TYPE NONE

LOCATION DATE CHARGE PENALTY

, (Rev. 04/16/2013)

EXPERIENCE AND QUALIFICATIONS – DRIVERLIST ALL DRIVER LICENSES OR PERMITS HELD IN THE PAST 3 YEARS

DRIVER LICENSES

STATE LICENSE NO. TYPE EXPIRATION DATE

A. HAVE YOU EVER BEEN DENIED A LICENSE, PERMIT OR PRIVILEGE TO OPERATE A MOTOR VEHICLE? YES NOB. HAS ANY LICENSE, PERMIT OR PRIVILEGE EVER BEEN SUSPENDED OR REVOKED? YES NO

IF THE ANSWER TO EITHER A OR B IS YES, GIVE DETAILS

DRIVING EXPERIENCE CHECK YES OR NO

CLASS OF EQUIPMENT TYPE OF EQUIPMENTDATES APPROX. NO. OF

MILES (TOTAL)FROM (M/Y) TO (M/Y)

STRAIGHT TRUCK YES NO

VAN TANK REFER

FLAT DUMP

TRACTOR AND SEMI-TRAILER YES NO

VAN TANK REFER

FLAT DUMP

TRACTOR – TWO TRAILERS YES NO

VAN TANK REFER

FLAT DUMP

TRACTOR – THREE TRAILERS YES NO

VAN TANK REFER

FLAT DUMP

MOTORCOACH – SCHOOL BUS

MORE THAN 8 PASSENGERS —

YES NO

MOTORCOACH – SCHOOL BUS

MORE THAN 15 PASSENGERS

—

YES NO

AUTO HAULER YES NO ENCLOSED OPEN

LIST STATES OPERATED IN FOR LAST FIVE YEARS:

SHOW SPECIAL COURSES OR TRAINING THAT WILL HELP YOU AS A DRIVER:

WHICH SAFE DRIVING AWARDS DO YOU HOLD AND FROM WHOM?

TO BE READ AND SIGNED BY APPLICANTThis certifies that this application was completed by me, and that all entries on it and the information in it are true and complete to the best of my knowledge.

SIGNATURE DATE

TYPE NAME

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