Phone: (585) 247-1909

BOON and Sons Inc. complies with the Federal Motor Carriers Safety Administration and the Code of Federal Regulations, Title 49: Transportation PART 391—QUALIFICATIONS OF DRIVERS AND LONGER COMBINATION VEHICLE (LCV) DRIVER INSTRUCTORS Subpart C—Background and Character § 391.21 Application for employment.

Please answer all questions

§ 391.21 (b)(2) The applicant's name, address, date of birth and social security number

List All Addresses for the Previous 3 years:

Emergency contact info:

Drivers License Information

Title 49: Transportation: PART 383— Subpart B—Single License Requirement § 383.21 Number of drivers' licenses. No person who operates a commercial motor vehicle shall at any time have more than one driver's license.

Driving Background & Qualifications

If Yes, please provide accident record for previous 3 years

If Yes, Please provide traffic convictions and forfeitures for previous 3 years, other than parking

Driving Experience

Straight Truck


Tandem Trailers


Employment History

In Accordance with the Code of Federal Regulations, Title 49: Transportation Part § 391.21 Application for employment. (b) (11) For those drivers applying to operate a commercial motor vehicle as defined by Part 383 of this subchapter, a list of the names and addresses of the applicant's employers during the 7-year period preceding the 3 years contained in paragraph (b)(10) of this section for which the applicant was an operator of a commercial motor vehicle, together with the dates of employment and the reasons for leaving such employment;

NOTE: List most recent employer first. Complete ALL information requested.


Schools attended

Military Service


Applicant: Read the following statement before signing and dating the Application Form

I authorize BOON and Sons Inc. to make any such inquiries and investigations of my current license status, driving history, FMCSA PSP, previous employment background, personal, financial and/or medical history. I hereby release state agencies, previous employers, schools, health care providers and/or any other person from all liability in connection to their responding to any and all inquiries from BOON and Sons Inc. , and the subsequent release of information to verify the accuracy of this application.

I understand that in the event of my employment by BOON and Sons Inc. , any false or misleading statements given in my application or interview(s) may result in my discharge. I also understand that I am required to abide by all rules and regulations of BOON and Sons Inc.

This certifies that this application was completed by me, and that all entries on it and information in it are true and complete to the best of my knowledge.

Learn more about our complete offering of residential and commercial refuse services in Rochester by calling Boon & Sons today at 585-247-1909. Ready to schedule your first trash pickup? Get started now by setting up your account online.

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