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Western Truck School

(800)929-1318

The road to a rewarding career

PHOENIX - TUCSON - LAS VEGAS

Contact Us

WESTERN TRUCK SCHOOL
PRE-APPLICATION FOR STUDENT TRAINING

First Name: *
Last Name: *
MI:
Address: *
City: *
State: *
Zip Code: *
Home Tel:No: *	- -
Cell: No:	- -
Alternate Ph: No:	- -

		YES	NO
You can read, write and Speak English Clearly? *
Are you a high school graduate or do you have a G.E.D? *
Do you have a valid driver's licence? *
Have you received any vehicular traffic citaiions in the last 3 years? *
Have you ever been convicated for a DWI or DUI ? .When?*
Have you ever had your licence suspender or revoked for any reason? *
Have you ever been certified to drive a commercial vehical? *
Have you physically lost any part of your body? *
Do you have any eyesight or hearing problem? *
Do you take any type of prcscribed medication? *
Do you have any physical mental disablities this at time? *
Are you presently employed either part time or full time? *
Can you verify employment/education history for the last 5 years? *
Have you ever been fired from a job? *
Have you ever sustained an on the job injury and/or been paid workers compansation? *
Have you ever filed or considered bankruptcy? *
Have you ever been convicted of felony charges(s)? *
Are you presently under indictment or charged with any type of crime *

	I am a citizen of United State of America
	I am a naturilized citizen of the United State of America
	I am a resident alien of the United State of America with employment Authorization card/Green Card

How did you here about Westren Truck School? *