4295 Harris Hill Road
Buffalo, New York 14221
716.276.2045  800.649.4939
Employment Application
Please take a moment to fill-out the employment form below to apply for a job posting.
 
Job Applying for
Position*
Personal Information* Indicates Required Fields
First Name*
Middle Name 
Last Name*
Social Security Number*
Date of Birth
E-mail Address
Address*
City*
State/Province*
Postal Code*
Telephone Number*
Area Phone No. Ext. Type


Current Employer Information
Employer Name
Contact
Dates of Employment
From
To 
Position
Pay
City
State/Province
Telephone Number
Area Phone No. Ext. Type


Past Employer Information
Past Employer
Contact
Dates of Employment
From
To 
Position
Pay
City
State/Province
Telephone Number
Area Phone No. Ext. Type
Why did you leave?


Past Employer(2) Information
Past Employer
Contact
Dates of Employment
From
To 
Position
Pay
City
State/Province
Telephone Number
Area Phone No. Ext. Type
Why did you leave?
 
Please read the statement below:

I certify that I personally completed this application and that all of the information is true and correct. I authorize Extra Mile Transportation, LLC., to conduct a thorough background investigation in accordance with state and federal law and authorize my previous employers to release any information requested by Extra Mile Transportation, LLC. and hold them harmless of all liability from the release of said information. Also, in accordance with the provisions of 49 CFR Part 382.405 and 382.413, I hereby authorize and require my previous and/or current employers specifically listed by me on this application to release the results (including any refusal to test) of all drug and alcohol tests taken by me pursuant to the provisions of 49 CFR while in their employment to Extra Mile Transportation, LLC. by whatever means is most expedient.
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Do you understand and agree with the above statement? (Please indicate your agreement by checking "yes" below.)
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