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Prospective employees and driver applicants please read the following information.

As an applicant for employment as a truck driver for Burak Express, Inc, you should be aware of the procedures involved to complete the process. We are very selective of the people that drive our trucks. As such, we go to great lengths to assure our customers and ourselves that the individuals we hire are capable and proficient in all areas that mark a professional and representative of Burak Express, Inc.

The following procedures and time frame for each phase is outlined below.

  • Applicant reads this entire letter and decides if they want to pursue the process and are willing to invest the time and commitment we seek from all our potential employees.
  • A job application form is issued, taken home and completely filled out. This includes a complete background of work history for the previous three years. Ten years of work history must be provided if you have been employed as a driver beyond the three years. A copy of your Motor Vehicle Record should also be returned to us. This MVR should be current up to the time of application with our Company.
  • Once we receive the completed employment application, your signature allows us to make reference checks with all employers listed for the previous three years. Make sure that the name of a contact person is listed along with correct addresses and telephone numbers. This usually takes up to three days. FMCSR Part 391.23 requires that investigation of an applicant be made with former employers and their comments be recorded with respect to the driver applicant. Such inquiries include reasons for leaving your former employer, character references, general conduct, safety habits, initiative, attitude, loyalty and disposition. Any other information that we deem appropriate as a qualifying factor for potential employment may be discussed.

Regulations of the Federal Highway Administration (FHWA) (49 CFR, Part 382.413) require us to make inquiries with your former employers(s) regarding their knowledge of, or test results concerning potential use of alcohol or controlled substances. This includes any refusals to be tested. As required by the FHWA, this information will be treated as strictly confidential and may not in itself necessarily be a bar to employment.

  • After the background check is completed we will contact you to set up an interview. Come prepared to perform a skills qualification-driving test. The test will include:
    1. a) Pre-trip inspection
    2. b) Actual driving of the truck
    3. c) Coupling and uncoupling
    4. d) Backing and Parking
    5. e) Courtesy and Safety
    6. f) General job knowledge
    7. g) Handling of freight
    8. h) Knowledge of Logbooks and D.O.T. regulations in general
  • The next step is the mandatory D.O.T. pre-employment drug screen. This is required and we insist that the employee applicant be prepared to pay the cost as a show of good faith and a genuine interest in becoming a driver for Burak Express, Inc. The cost of the test is fifty-four dollars. The cost of the test will be reimbursed to the employee, if hired, successfully completes probation and is currently receiving satisfactory job appraisals after six months of continuous service.
  • At this point, the information we have concerning all the areas previously covered will be presented to the supervisory committee. This committee will review all the information provided and make a recommendation based on the results.
  • If the applicant is qualified and has verifiable experience the hiring process will progress to the orientation phase and required paperwork. This phase generally takes up to a half a day. The new employee will be interviewed by the dispatch representative, accounts receivable, shop foreman and finally the President of the company.
  • Once orientation is completed and the Safety department has received a negative drug result, an initial run will be scheduled with a designated Driver/ Evaluator. This individual will determine if the new employee is in fact ready for his own truck or if further training or evaluation is necessary. Whichever is the case, the new employee will be in Probation for the first ninety days and subject to all the various criteria outlined in that policy.
  • Performance appraisals will be conducted at thirty-day intervals during the Probationary period.
  • After ninety days a meeting of the supervisory personnel will be conducted. At this time the performance appraisals will be reviewed and further continued employment will be either recommended or rejected.
  • This letter is not to be interpreted as an employment contract or intent for regular employment. Burak Express, Inc reserves the right to terminate any and all employees at any time, for any reason, with or without notice, and with or without cause. Completion of the introductory period or conferral of regular status does not change an employee’s status as an employee-at-will or in any way restrict the company’s right to terminate such an employee or change the terms or conditions of employment. Any and all company recruiting material, company memoranda, or other materials provided to applicants or employees shall not be considered as creating any contractual obligation on the company’s part and is subject to revision, deletion or modification at any time without notice, written or otherwise, to the applicant or employee.
PLEASE NOTE: This is part of your application and must be signed. If any of the above seems objectionable to you, please reconsider your desire to be employed by Burak Express, Inc.



Motor carriers have the responsibility to make the following investigations and inquiries with respect to each driver employed, other than a person who has been a regularly employed driver of the motor carrier for a continuous period, which began before January 1, 1971.

  • (1) An inquiry into the driver’s driving record during the preceding three years to the appropriate agency of every State in which the driver held a motor vehicle operator’s license or permit during those three years; and (2) An investigation of the driver’s employment record during the preceding three years.
  • A copy of the driver record(s) obtained in response to the inquiry or inquiries to each State driver record agency as required must be placed in the Driver Qualification File within 30 days of the date the driver’s employment begins and be retained in compliance with 391.51.
  • Replies to the investigations of the driver’s safety performance history must be placed in the Driver Investigation History File within 30 days of the date the driver’s employment begins.
  • Prospective motor carrier must investigate the information from all previous employers of the applicant that employed the driver to operate a CMV within the previous three years. This information must cover general driver identification and employment verification information, data elements as specified in 390.15 for accident involving the driver that occurred in the three-year period preceding the date of the employment application, and any accidents the previous employer may wish to provide.
  • Prospective motor carrier must investigate the information from all previous DOT regulated employers that employed the driver within the previous three years from the date of the employment application in a safety-sensitive function that required alcohol and controlled substance testing specified by 49 CFR Part 40.
Drivers have the following rights:
  • The right to review information provided by previous employers.
  • The right to have errors in the information corrected by the previous employer and that previous employer to resend the corrected information to the prospective employer.
  • The right to have a rebuttal statement attached to the alleged erroneous information, if the previous employer and the driver cannot agree on the accuracy of the information.

Drivers who wish to review previous employer-provided investigative information must submit a written request to the prospective employer when applying or as late as 30 days after employed or being notified of denial of employment. The prospective employer must provide this information to the applicant within five business days of receiving the written request. If the driver has not arranged to pick up or receive the requested records within 30 days of the prospective employer making them available, the prospective motor carrier may consider the driver to have waived his/her request to review the records.

Drivers wishing to request correction of erroneous information in records must send the request for the correction to the previous employer that provided the records. The previous employer must either correct and forward the information to the prospective motor carrier employer or notify the driver within 15 days of receiving the driver’s request to correct the data that it does not agree to correct the data. Drivers wishing to rebut information in records must send the rebuttal to the previous employer with instruction to include the rebuttal in the driver’s Safety Performance History.

I acknowledge that I have read and understand the contents of this document.

CFR Part 40.25(j) requires the employer to ask any applicant, whether he or she has tested positive, or refused to test, on any pre-employment drug or alcohol test administered by an employer to which the employee applied for, but did not obtain, safety-sensitive transportation work covered by DOT agency drug and alcohol rules during the past two years. If the potential employee admits that he or she had a positive test or refusal to test, we must not use the employee to perform safety-sensitive function, until and unless, the potential employee provides documentation of successful completion of the return-to-duty process. (See Section 40.25 (b)(5) and (e).

As an applicant, applying to perform safety sensitive functions for Burak Express, Inc, you are required by CFR Part 40.25(j) to respond to the following questions.

1. Have you ever tested positive, or refused to test, on any pre-employment drug or alcohol test administered by an employer to which you applied for, but did not obtain, safety-sensitive transportation work covered by DOT agency drug and alcohol testing rules during the past two years?

  • Yes
2. If you answered yes, to the above question, can you provide proof that you’ve successfully completed the DOT return-to-duty requirements?
  • Yes
My signature below certifies that the information provided is true and correct.


The purpose of this application is to determine whether or not the applicant is qualified to operate motor carrier equipment according to the requirements of the Federal Motor Carrier Safety Regulations and Burak Express, Inc.

Instructions to Applicant: Please answer all questions. If the answer to any question is “No” or “None”, do not leave the item blank, but write “No” or “None”.


  • The Age Discrimination of Employment Act of 1967 prohibits discrimination on the basis of age with respect to individuals who are 40 years of age or older

  • No

  • From

Education History :
Please circle the highest grade completed:
  • 1
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  • 5
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  • 7
  • 8
  • 9
  • 10

  • 1
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Employment History :

Give a complete record of all employment for the PAST THREE YEARS, including any unemployment or self- employment, AND ALL COMMERCIAL DRIVING EXPERIENCE FOR THE PAST TEN YEARS.

Current Company:
To :

Were you subject to the FMCSRs* while employed here?


Was 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?


Previous Company:
To :

Were you subject to the FMCSRs* while employed here?


Was 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?


Previous Company:
To :

Were you subject to the FMCSRs* while employed here?


Was 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?


Previous Company:
To :

Were you subject to the FMCSRs* while employed here?


Was 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?


*The Federal Motor Carrier Safety Regulations (FMCSRs) apply to anyone who operates a motor vehicle on a highway in interstate commerce to transport passengers or property when the vehicle: (1) has a GVWR or weighs 10,001 pounds or more, (2) is designed or used to transport nine or more passengers, or (3) is of any size, used to transport hazardous materials in a quantity requiring placarding.

Driving Experience:

Class of Equipment

From (mo/yr):

To (mo/yr):

Approximate # of Miles (Total)

  • Straight Truck
  • Tractor and Semi-trailer
  • Tractor and two trailers (doubles)
  • Tractor and three trailers (triples)
  • Other
List states operated in, for the last five years:

List special courses/ training completed (PTD/DDC, HazMat,etc.):

List any Safe Driving Awards you hold and from whom:
Accident Record for past three years (attach sheet if more space is needed)

Date of Accident

Nature of Accidents
(Head on, rear end, upset, etc.)

of Accident

# of

# of
People Injured

Traffic Convictions and Forfeitures for the last three years (other than parking violations)





Driver’s License (list each driver’s license held in the past three years)


License #



Expiration Date

  • Have you ever been denied a license, permit or privilege to operate a motor vehicle?
  • Has any license, permit or privilege ever been suspended or revoked?
  • Have you ever tested positive or refused a DOT drug or alcohol pre-employment test within the last three years from an employer who did not hire you
  • Have you ever been convicted of a felony
If the answers to A, B, C or D is “YES”, give detail

List three persons for references, other than family members, who have knowledge of your safety habits.

To Be Read and Signed by Applicant

It is agreed and understood that any misrepresentation given on this application shall be considered an act of dishonesty.

  • It is agreed and understood that Burak Express, Inc. or his agent(s) may investigate the applicant’s background to ascertain any and all information of concern to applicant’s record, whether same is of record or not, the applicant releases employers and persons named herein from all liability for any damages on account of his furnishing such information.
  • It is also agreed and understood that under the Fair Credit Reporting Act, Public Law 91-508, I have been told that this investigation may include an investigating Consumer Report, including information regarding my character, general reputation, personal characteristics, and mode of living.
  • I agree to furnish such additional information and complete such examinations as may be required to complete my application file.
  • It is agreed and understood that this Application for Qualification in no way obligates Burak Express, Inc to employ or hire the applicant.
  • It is agreed and understood that if qualified and hired, I may be on a probationary period during which time I may be disqualified without recourse.
My signature certifies that I have completed the application, and to the best of my knowledge, all entries and the information provided are true and complete.

Request for Driver’s Safety Performance History

Information from DOT Regulated Previous Employer(s)

  • From:
    Contact Person:
  • Address:
    City, State, Zip:
  • Phone Number:
    Confidential Fax#:
    Email Address:
Driver to complete this section

As a Commercial Motor Vehicle (CMV) Driver, I understand that per the Federal Motor Carrier Safety Regulations (FMCSR) Part 391.21, the following information will be requested from all previous Employers for which I operated a CMV, subject to the FMCSR Parts 390 and/or 40, 382 & 383, within the past three years, from date shown below. I also acknowledge that this information will be used in determining my eligibility to be hired, that I have the right to review this information and rebut any errors in these statements from my prior employers, as described in the FMCSR Part 391.23.

I , hereby authorize this Company to release all records of employment including assessments of my job performance, ability and fitness (including dates of any and all alcohol or drug tests, those confirmed results and/or my refusal to submit to any alcohol or drug tests and any rehabilitation completion under direction of (SAP/MRO) to each and every company (or their authorized agents) which may request such information in connection with my application for employment with said company. I hereby release this company, and its employees, officers, directors and agents from any and all liability of any type as a result of providing information to the above mentioned person and/or company.

  • Previous Employer:
    Contact Person:
  • Mailing Address:




  • Telephone Number:

    Fax Number:

I worked for this Company from the Company from of:
To :

Past Employer to Complete >> DRUG & ALCOHOL INFORMATION
Please provide the following Drug and Alcohol information as required by FMCSR Part 391.23 & 40.25.
If no Drug and Alcohol information is available on above named applicant check here:

  • Any alcohol test with a result of 0.04 or higher alcohol concentration? Yes No
  • Any verified positive drug test? Yes No
  • Any refusals to be tested (include verified adulterated or substituted drug test results?) Yes No
  • Any other violations of DOT agency drug & alcohol testing regulations (Part 282 or Part 40)? Yes No
  • If this Driver did successfully complete a SAP rehabilitation referral and remained Yes No
  • in your employ, did he/she have any subsequent violations for; an Alcohol test result of 0.04 or greater, a verified positive drug test or a refusal to test ( including a verified adulterated/ substituted drug tests result)? Yes No
  • If yes to any of the above questions, please provide documentation of successful completion of a SAP evaluation, prescribed treatment and return-to-duty requirements (including follow-up tests) if they remained in your employ*. Yes No

Additional Remarks (anything relevant, whether positive or negative, about your specific experience with the above-named driver)

If this information is not available from the previous employer, you as a prospective employer, must get this information from the Driver/Applicant. Drug and Alcohol information needs to be kept in a separate Personnel and/or Confidential file.