Lead Mechanic Application - Seagull Disposal

We are looking for a skilled and experienced Mechanic to join our team. As a Mechanic, you will be responsible for maintaining and repairing our fleet of vehicles, ensuring they are in optimal working condition. A CDL driver’s license is required for the position. The ideal candidate will have a strong mechanical aptitude, attention to detail, and a passion for problem-solving.

If you have any questions, please email us at careers@seagulldisposal.com.

Employment Application

First Name *

Last Name *

Phone *

Email *

Date Of Birth *

Position Applied For *

Date Available For Work *

Do You have Legal Right To Work in The United States? *
YesNo

Previous Three Years Residency

Please include street, city, state, and zip code.

Current Address *

Second Most Recent Address

Third Most Recent Address

Fourth Most Recent Address

Licensing Information

State *

License Number *

Type/Class *

Endorsements *

Expiration Date *

Previously held licenses

Driving Experience

Current (Most Recent)

Class of Equipment *

Type of Equipment *

Date From *

Date To *

Approximate Miles Driven *

Second (Most Recent)

Class of Equipment

Type of Equipment

Date From

Date To

Approximate Miles Driven

Third (Most Recent)

Class of Equipment

Type of Equipment

Date From

Date To

Approximate Miles Driven

Accident Record For Past 5 Years

Nature of Accidents (List dates, fatalities, injuries, and chemical spills) *

Traffic Convictions and Forfeitures For Past 5 Years

Violations (List dates, violations, state of violation, and penalty) *

Have you ever been denied a license, permit, or privilege to operate a motor vehicle? *
YesNo

Have you ever had a license, permit, or privilege suspended or revoked? *
YesNo

Employment History

Current (Most Recent) Employer

Name *

Phone *

Address *

Position Held *

From *

To *

Reason For Leaving *

Salary *

Explain Any Gaps In Employment (include month/year & reason)

While employed here, were you subject to the Federal Motor Carrier Safety Regulations? *

Was the job designated as a safety-sensitive function in any Department of Transportation-regulated mode subject to alcohol and controlled substances testing as required by 49 CFR, part 40? *

Second (Most Recent) Employer

Name

Phone

Address

Position Held

From

Reason For Leaving

Salary

Explain Any Gaps In Employment (include month/year & reason)

While employed here, were you subject to the Federal Motor Carrier Safety Regulations?

Was the job designated as a safety-sensitive function in any Department of Transportation-regulated mode subject to alcohol and controlled substances testing as required by 49 CFR, part 40?

Third (Most Recent) Employer

Name

Phone

Address

Position Held

From

Reason For Leaving

Salary

Explain Any Gaps In Employment (include month/year & reason)

While employed here, were you subject to the Federal Motor Carrier Safety Regulations?

Was the job designated as a safety-sensitive function in any Department of Transportation-regulated mode subject to alcohol and controlled substances testing as required by 49 CFR, part 40?

Education

High School

Name & Location *

Years Completed *

Graduate *

Details

College

Name & Location

Course of Study

Years Completed

Graduate

Details

Other

Name & Location

Course of Study

Years Completed

Graduate

Details

Other Qualifications

Please list any other qualifications that you have and which you believe should be considered.

To Be Read And Signed By Applicant

I authorize you to make investigations (including contacting current and prior employers) into my personal, employment,
financial, medical history, and other related matters as may be necessary in arriving at an employment decision. I hereby
release employers, schools, health care providers, and other persons from all liability in responding to inquiries and releasing
information in connection 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 also understand that I am required to abide by all rules and regulations of the Company.

I understand that the information I provide regarding my current and/or prior employers may be used, and those employer(s)
will be contacted for the purpose of investigating my safety performance history as required by 49 CFR 391.23. I understand
that I have the right to:

• Review information provided by current/previous employers;
• Have errors in the information corrected by previous employers, and for those previous employers to resend the
corrected information to the prospective employer; and
• Have a rebuttal statement attached to the alleged erroneous information, if the previous employer(s) and I cannot
agree on the accuracy of the information.

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. Note: A motor carrier may require an applicant to provide more information than that required by the
Federal Motor Carrier Safety Regulations.

Applicant Digital Signature *

Date *