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Call (414) 274-3000

AU Transportation Group

Home
About Us
- Driver Portal
Services
Safety
Driver Opportunities
- Driver Application
Contact Us
- Lost & Found

Driver Application

You can complete the Driver Application form below online or download our Printable Driver Application form and bring to our office.

Please download our Driver Application Information sheet for more information on driver requirements and responsibilities.

Your Information:
Name*
First Last
Cell Phone*
Home Phone*
Date of Birth*
MM slash DD slash YYYY
Email*
Address*
Street Address Address Line 2 City State ZIP Code
Driver's License Information:
Do you have a City of Milwaukee issued (PPL) Public Passenger Drivers License?
If yes above what is the license #?
Expiration Date
MM slash DD slash YYYY
WI Driver’s License Number
Are you certified to handle wheelchairs?
Do you have a valid First Aid/CPR certification?
Accident Record for the Past 5 years:
Nature of Accident
Accident Date
MM slash DD slash YYYY
Fatalities
Injuries
Add second accident info?
- Yes
- No
Nature of Accident
Accident Date
MM slash DD slash YYYY
Fatalities
Injuries
Add third accident info?
- Yes
- No
Nature of Accident
Accident Date
MM slash DD slash YYYY
Fatalities
Injuries
Driving Experience:
Have you driven a medical van in the past?
If yes for how long?
If you drove a medical van in the past for what company?
Employment History Questions:
Have you ever been convicted of a felony?
- Yes
- No
How did you hear about us?
If part time tell us when: (check all that apply)
- Week days-daytime hours.
- Week end-daytime hours.
- Week days-evening hours.
- Week end-evening hours.
To Be Read And Signed By Applicant
This certifies that I completed this application, and that all entries on it and information in it are true and complete to the best of my knowledge. I authorize you to make such investigations and inquire of my personal, employment, financial or medical history and other related matters as may be necessary in arriving at an employment decision. (Generally, inquires regarding medical history will be made only if and after a conditional offer of employment has been extended.) I hereby release employers, schools, health care providers and other persons from all liability in responding to inquiries and releasing information in connections with my application. In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the Company.
Do you authorize American MedTrans to run a personal and employment background check?*
- Yes, I approve
- No
Enter Today's Date*
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Comments
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