(Billing: x301)


Driver Application Form

Thrifty Propane Location: Region/District/Branch
Company Address State: ZIP:

Thrifty Propane

PO BOX 2018
Medina, OH 44258
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I authorize you to make such investigations and inquiries of my personal, employment, financial or medical history and other matters as may be necessary in arriving at an employment decision. (Generally, inquiries 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 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 understand, also, that I am required to abide by all rules and regulations of the Company.

"I understand that information I provide regarding current and/or previous 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(d) and (e). 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 re-send 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 cannont agree on the accuracy of the information."
In lieu of Signature, please provide the following:
Full Legal Name: Numeric 4 Digit PIN: (ex. 1234)

First Name:   Middle Name:   Last Name:
Date of Birth: / / (mm/dd/yyyy)
Contact Phone: (ex. 123-456-7890) Email:
Driver's License # License State
City: State: County: ZIP:

Please check the appropriate box
What type of Employment are you seeking?
Do you have a CDL? If yes, please select the type:
Do you have hazmat endorsement on CDL?
Do you have tanker endorsement on CDL?
Do you have experience related to propane, such as natural gas or fuels?
Are you over the age of 25?
How many years of driving experience do you have?
Do you have Propane Delivery Experience (Bobtail)?
Do you have Fuel Oil Home Delivery Experience?
Do you have Tank Setting Experience (Service)?
Do you have Propane Transport Experience Experience (Tanker/Tractor)?
Have you had more than 2 violations on License in the past 3 years?
How did you hear about this position?

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