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Professional Drivers Academy
Application For Training

Completion of this application is to determine your

qualifications for training. This is not a contract.

All answers are confidential.

U.S. Citizen?
Which of the following are your reasons for furthering your training now?
PHYSICAL FITNESS
Are you in good health?
Do you have at least 20/40 vision in both eyes with glasses?
Do you have use of Hands?
Arms?
Feet?
Legs?
Good Hearing?
Do you have any condition which could cause fainting spells?
Use of intoxicants:
Have you ever had a drug test?
Can you pass a drug test today?
Any physical defects?
EDUCATION
Highest education completed
Do you have a diploma, G.E.D. Equivalency or Correspondence certificate?
DRIVING RECORD
Ever been revoked or suspended?
Have you ever been convicted of driving under the influence of alcohol / drugs?
Have you ever been bonded?
Bond ever refused?
EXPERIENCE
Have you had any experience in truck driving?
FOR VETERANS ONLY
Ever received Vet benefits?

PDA ADMITS, TRAINS, AND REFERS STUDENTS WITHOUT REGARD TO RACE, COLOR, SEX, OR NATIONAL ORIGIN.

PDA DOES NOT GUARANTEE EMPLOYMENT.

I UNDERSTAND THAT IN COMPLETING THIS APPLICATION, THE SCHOOL IS UNDER NO OBLIGATION TO ACCEPT ME, NOR AM I UNDER OBLIGATION TO PROFESSIONAL DRIVERS ACADEMY. It is agreed and understood that the answers to the foregoing questions are true and correct, and that any misrepresentation of information given above shall be considered an act of dishonesty. 

Thanks for applying! We’ll get back to you soon.

FOR OFFICE USE ONLY - DO NOT WRITE BELOW
I have interviewed this applicant and have reviewed his / her qualifications. I recommend:
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