CDL Training Las Vegas Registration

Date

Name:

Email:

Phone:

Select Your Purchased Course:

Address:

Are you eligible to work in the U.S?

Yes No

Drivers License #:

Do you currently have a CDL?

If 'YES' From What State?

If 'YES' From What Class?

How Many Years Has It Been Since Your CDL?

Do You Have Experience Driving Commercial Motor Vehicles?

If 'YES' How Many Years?

Please Describe Your Experience:

Have You Ever Had Your Driving Privileges Revoked Or Suspended?

If 'YES' Please Describe:

Are you over 18 years of age?

Yes No

Are you over 21 years of age?

Yes No

Ever been convicted of a Felony?

Yes No

Any citations in the last 3 years?

Yes No

Ever convicted of a DUI or DWI?

Yes No

Cicted of Drug Trafficking?

Yes No

US Military Veteran?

Yes No

Reliable transportation?

Yes No

Are you currently under a doctors care?

Yes No

Please list any document disabilities, physical limitations, or chronic health problems that we restrict the type of jobs you can have

Educational History List any other skills, training or experience you have computer classes, typing skills, etc.

Equal Opportunity is the Law
CDL Training Las Vegas is an equal opportunity employer and does not discriminate against any individual based on race color, religion, sexual orientation, national origin, age, disabilities, political, affiliation, or belief.
I understand that to be eligible to attend the CDL Training Las Vegas, I must successfully pass a drug screening test as well as complete a background check. I hear by certify that all the information provided on this application is true and complete to the best of my knowledge if this application leads to admission, I understand that false or misleading information in my application or interview may result in dismissal from CDL training Las Vegas.

Select this box to agree to the Terms of Use for CDL Training Las Vegas and authorize a representative to prepare your enrollment agreement to begin your course with CDL Training Las Vegas.

REGISTRATION