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CALL TOLL-FREE FOR MORE INFORMATION: 1-800-752-5319 (U.S. & Canada) OR VISIT OUR WEB SITE: www.schneider.com IF IN THE MILITARY, AND STATIONED IN ONE OF THE FOLLOWING COUNTRIES, YOU CAN STILL CALL TOLL-FREE: 1-800-444-77433 • DENMARK • FRANCE • GERMANY • IRELAND • ITALY • JAPAN • SOUTH KOREA • UNITED KINGDOM • IN SPAIN CALL: 900-96-1270 Schneider National Inc. P.O. Box 2417 Green Bay, WI 54306-2417 ©2004 Schneider National Inc. All rights reserved. Information in this publication is subject to change without notice. Meeting the basic qualification criteria outlined in this document does not guarantee you a driving position with Schneider National Inc. 482-0421 10/2004 RATED APPLICANT A GUIDE TO CONTINUE THE PROCESS OF BECOMING A SCHNEIDER NATIONAL DRIVER CONDITIONAL JOB OFFER • DRIVER QUALIFICATION FILE • COMMERCIAL DRIVER LICENSE • CONTINUATION FORMS • RATED• APPLICANT • Congratulations! You have been offered a Conditional Job Offer To continue in the process, you must complete the paperwork contained in this brochure. Part of the conditional job offer is that you must meet the following requirements: Obtain your Class A Commercial Driver License (CDL) Permit*, pass your Department of Transportation (DOT) physical and drug screen, return all required paperwork to complete your Driver Qualification File and successfully complete the pre-hire training.** Now that you have accepted our conditional job offer, we will begin working on your Driver Qualification File. Per DOT regulations, we are required to research your personal history. This should not be of concern to you, provided you have disclosed all requested and/or required information. The information used to assemble your Driver Qualification File must meet or exceed our hiring criteria. Your application must be true and accurate. You do not officially become a Schneider employee and begin to earn pay until you successfully complete the training. *Experienced drivers will already have their Class A Commercial Driver License. **The training period is different for experienced, Bulk and Specialized drivers. • The Driver Qualification File The DOT requires Schneider National to have a complete Driver Qualification File. We are required to research your driving record, your employment history and your physical condition (including drug and alcohol screening). We will also do a criminal check. Return Materials Today Additional information must be provided to complete your file. We ask that you obtain and provide it as quickly as possible. All items listed below must be submitted within five days or it will result in a delay in scheduling your training. If you do not have all of your forms right away, please do not hold up the process. Send what you have and then send other pieces as soon as you obtain them.  Copy of your driver license  Copy of your signed social security card  Copy of your Class A CDL Permit or Class A CDL  Certified copy of your birth certificate (or current passport, voter registration card or green card)  Copy of your DD214, Member 4 (required only if you have been in the military during the last three years)  Copy of tractor-trailer driving school diploma (only if you have graduated within the last three years) The photocopies made of these documents should be as clear as possible. We recommend the photocopies be enlarged, and must be copied one document per page. You must also complete additional forms included in this brochure. This information is a necessary part of your Driver Qualification File. Please read through the forms carefully, fill them out completely and return to us as quickly as possible.  Pages 5-12 of of the Rated Applicant Booklet • How do I go about getting my Commercial Driver License? If you do not currently possess a Class A CDL, you should immediately apply and start studying for the learner's permit. You can obtain an application and study guide from the Department of Motor Vehicles (in the state in which you are going to reside). The cost varies by state, but generally the study guide is free and testing for your CDL Permit is in the $10-$60 range. In addition to the state study guide, Schneider National provides a CDL Permit Study Guide. The Schneider National CDL Permit Study Guide is also available online at www.schneider.com/drivers/training.html#cdlprep. You must complete the written portion of the CDL Permit at least one week prior to Schneider National's training. You must pass the tests for the following areas of study*: 1) General Knowledge 2) Combination Vehicles 3) Air Brakes 4) Hazardous Materials (HazMat) 5) Tanker (only for those individuals joining Schneider National Bulk Carriers) Once you have passed these tests, you will obtain a CDL Learner's Permit. This process can take as long as four weeks in some states, so don't delay! Behind-the-wheel training takes place at a Schneider National training facility. Each state has different rules and regulations regarding testing and awarding of the CDL. For some states, your CDL driving test will be administered at a Schneider National facility. However, some states require you to return to a state agency to be tested (after learning to drive at Schneider), and some states require you to schedule your CDL road test before coming to training. A Schneider National representative will help you through the entire process, don’t be afraid to ask questions. *Tests may vary by state. Texas residents may be required to complete additional CDL permit tests. Please ask a Schneider Representative for details. 2 • Mutual Expectations: A review of the hiring process Hiring the best drivers is a priority at Schneider National. Our customers demand it. We demand it. That's why a candidate seeking employment with Schneider National must complete an application, meet specific requirements, be successful through our interview process and background check, have an acceptable Motor Vehicle Record and work history. A candidate must also pass a physical examination. After you complete the enclosed forms, we will schedule you for training. Employment will begin after the successful completion of pre-hire training (company-paid training) for inexperienced individuals or orientation (three and a half days) for experienced drivers. • You’re on the way to the finest training with the best carrier in the industry! Wondering what to pack? Here is a list of items that you will need to bring to training:  Comfortable clothing for the duration of your training or orientation. Include boots or shoes with non-skid soles, an insulated pair of coveralls (for winter months) and work gloves. Shorts and non-essential jewelry are not allowed for safety reasons. Soft-sided luggage is recommended.  A pair of sunglasses  A flashlight  A watch  Classroom materials to include a pen, pencil, paper, hand held calculator, 12-inch ruler, highlighter, one-inch 3-ring binder and a briefcase or book bag. If you are an inexperienced driver going through the training program, we recommend you bring $200 for miscellaneous expenses. When you get to training, you will be required to fill out additional forms for our payroll and benefits department. This paperwork will be done in class, so come prepared. Bring the following materials with you even if you have already submitted them:  Class A CDL Permit or Class A CDL  Documents to show identity and employment eligibility (see a list of acceptable documents below)  Birth Certificate, passport, green card or voter registration card  Schneider offers direct deposit of your paycheck. Please bring a voided blank check for deposit into your checking account (deposit slips are not acceptable) or a MICR sheet (obtained from your financial institution) for deposit into your savings account.  Names, addresses, Social Security Numbers and birth dates of dependents for medical insurance paperwork  DOT medical card (obtained at the physical examination) • Identity and employment eligibility documents You will need to provide one document from List A OR one document each from List B and C. Acceptable documents include: LIST A Documents that establish both identity and employment eligibility 1. U.S. Passport (unexpired or expired) 2. Certificate of U.S. Citizenship (INS Form N-560 or N-561) 3. Certificate of Naturalization (INS Form N-550 or N-570) 4. Unexpired foreign passport, with I-551 stamp or attached INS Form I-94 indicating unexpired employment authorization 5. Alien Registration Receipt Card with photograph (INS Form I-151 or I-551) 6. Unexpired Temporary Resident Card (INS Form I-688) 7. Unexpired Employment Authorization Card (INS Form I-68 8A) 8. Unexpired Re-entry Permit (INS Form I-327) 9. Unexpired Refugee Travel Document (INS Form I-571) 10. Unexpired Employment Authorization Document issued by the INS which contains a photograph (INS Form I-68 8B) 3 LIST B Documents that establish identity 1. Driver license or ID card issued by a state or outlying possession of the United States provided it contains a photograph or information such as name, date of birth, sex, height, eye color and address 2. ID card issued by federal, state or local government agencies or entities, provided it contains a photograph or information such as name, date of birth, sex, height, eye color and address 3. School ID card with a photograph 4. Voter Registration Card 5. U.S. Military Card or draft record 6. Military Dependents ID Card 7. U.S. Coast Guard Merchant Mariner Card 8. Native American tribal document 9. Driver license issued by a Canadian government authority LIST C Documents that establish employment eligibility 1. U.S. Social Security Card issued by the Social Security Administration (other than a card stating it is not valid for employment) 2. Certification of Birth Abroad issued by the Department of State (Form FS-545 or Form DS-1350) 3. Original or certified copy of a birth certificate issued by a state, county, municipal authority or outlying possession of the United States bearing an official seal 4. Native American tribal document 5. U.S. Citizen ID Card (INS Form I-197) 6. ID Card for use of Resident Citizen in the United States (INS Form I-179) 7. Unexpired employment authorization document issued by the INS (other than those listed under List A) AND OR RATED• APPLICANT • Rated Applicant Continuation Forms Please fill out the following forms on pages 4-9 COMPLETELY and detach along the perforated edges. Return the completed forms to Schneider National as soon as possible. Incomplete forms will delay your processing. Gray areas are for office use only. Please do not mail the entire booklet as you may need to refer to it later. 4 All applicants with one or more periods of unemployment for over 30 days in the past three years, MUST complete the information below. Information given on this document should match your original application and left blank ONLY if there are no periods of unemployment to report. To be completed by Applicant: I, _________________________________________, Social Security number _______________________, do hereby affirm the following dates as periods of unemployment within the last three years (falsification will result in termination of the hiring process). 1) From (mo/yr): _____ / _____ To (mo/yr): _____ / _____ 4) From (mo/yr): _____ / _____ To (mo/yr): _____ / _____ 2) From (mo/yr): _____ / _____ To (mo/yr): _____ / _____ 5) From (mo/yr): _____ / _____ To (mo/yr): _____ / _____ 3) From (mo/yr): _____ / _____ To (mo/yr): _____ / _____ 6) From (mo/yr): _____ / _____ To (mo/yr): _____ / _____ Applicant’s Name: _______________________________________________________ Date: _________________________ Applicant’s Signature: ____________________________________________________ To be completed by Personal Reference: This information is subject to verification and must be completed by a non-relative. To the best of my knowledge, the unemployment information provided by the applicant is true and accurate: Reference’s Name: ________________________________________ Occupation: ___________________________________ Reference’s Signature: _____________________________________ Home Telephone: ( _________) ____________________ Relationship to Applicant: ___________________________________ Number of Years You Have Known Applicant: __________ To be completed by Personal Reference: This information is subject to verification and must be completed by a non-relative. To the best of my knowledge, the unemployment information provided by the applicant is true and accurate: Reference’s Name: ________________________________________ Occupation: ___________________________________ Reference’s Signature: _____________________________________ Home Telephone: ( _________) ____________________ Relationship to Applicant: ___________________________________ Number of Years You Have Known Applicant: __________ Schneider National, Inc. Affidavit of Unemployment History Violation and Review Record Driver’s Name (print): __________________________________________ Date of Birth: ________________ SS#: ________________________ Last Middle First Current Driver License #: ________________________________________ State: ______________________ Expires on: __________________ (mm/dd/yy) Certification of Violations (Reg. 391.27) I certify that the following is a true and complete list of traffic violations with any type of motor vehicle (car, truck, motorcycle, etc.), other than parking violations, for which I have been convicted or forfeited bond or collateral during the past 12 months. (If no moving violations in the past 12 months, write “NONE” below). If no violations are listed, I certify that I have not been convicted or forfeited bond or collateral on account or any violation required to be listed during the past 12 months. Date of Offense City/State Type of Vehicle Operated __________________________ __________________________ __________________________ ________________________ __________________________ __________________________ __________________________ ________________________ __________________________ __________________________ __________________________ ________________________ By completing and submitting this form, I authorize Schneider National, Inc. and/or its affiliates and subsidiaries (“Schneider”) to obtain consumer reports from any appropriate consumer reporting agency and understand that such consumer reports may be used by Schneider in the determination of whether or not to continue my employment and/or Independent Contractor operating agreement. Driver’s Signature:______________________________________________ Date of Certification (today’s date): ______________________ Review and Evaluation of Driver’s Record: In Accordance with Section 391.25, Motor Carrier Safety Regulations, all information pertinent to the above driver’s safety of operations, including the list of violations furnished by him/her in accordance with Section 391.27, has been reviewed for the past 12 months. Action taken: ____________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________________________ SCHNEIDER NATIONAL, INC. and/or its affiliates GREEN BAY,WI 54306 (Motor Carrier’s Name) (Motor Carrier’s Address) (Reviewed by: Signature) (Date) Certification by Driver I hereby certify that I understand the driver provisions of the Commercial Motor Vehicle Safety Act of 1986 that became effective July 1, 1987. In summary it states: • Commercial motor vehicle operators can only carry one license issued from their home state. • Upon conviction of a traffic violation (other than parking) you must notify your home state, that which issued your license, and your motor carrier of such conviction immediately. • Drivers with additional licenses must return them in the issuing state. • Failure to comply is a violation of Federal regulations and can subject the individual to a significant fine. Driver’s Name (print): ______________________________________________________________ SS#: ______________________________ Last Middle First Driver’s Residence Address: ________________________________________ City: ____________________ State: ______ Zip: __________ CDL Permit #:______________________________________________________________________ State: ____________________________ Class A CDL License #: ______________________________________________________________ State: ____________________________ I further certify that the above commercial vehicle license is the only one held or that I have surr endered the following CDL licenses to the states indicated. State: ____________________________________ Type/Class: ________________________________ Lic.#: __________________________ State: ____________________________________ Type/Class: ________________________________ Lic.#: __________________________ Driver’s Signature: __________________________________________________________________________________________________ Reviewed by: _____________________________________________________________________ Date: _________________________ For Office Use Only For Office Use Only 5 Certification of Compliance PLEASE FILL OUT THIS PAGE COMPLETELY, INCLUDING THE ORANGE SHADED AREAS. Medical Release Authorization and confirmation of understanding of drug use policy I am fully aware, and give my authorization that I will be required to, and agree to submit to a physical examination and testing for drug and alcohol use as part of the company’s evaluation procedure. I authorize the release of my results and any and all prior medical records required for this evaluation to the employer. I further authorize the employer’s unrestricted use of those results in deciding whether I should be offered employment. I am fully aware that it is Schneider National’s policy that evidence of drug use prior to or during my employment will be grounds for immediate termination without recourse and without notice. Signature: __________________________________________________ Date: ______________________________ Social Security #: ________ / ________ / ________ 6 7 SCHNEIDER NATIONAL, INC AUTHORIZATIONS AND CERTIFICATIONS: I understand that as part of the Department of Transportation Driver Qualification process (specifically DOT 49 CFR Parts 382 CONTROLLED SUBSTANCES AND ALCOHOL USE AND TESTING) Schneider National, Inc. and its subsidiaries (Schneider National Carriers, Schneider National Bulk Carriers, Schneider Tank Lines, Schneider Specialized Carriers, Schneider Transport, Schneider Training Academy) are required to obtain the results of all DOT required drug and/or alcohol tests (including refusals to be tested). I understand that I must give Schneider National, Inc. written authorization to obtain the above mentioned information from all of the companies for which I performed a safety sensitive function, or for which I took a pre-employment drug and/or alcohol test, during the past three years. I also understand that my signing of the authorization does not guarantee me a job/lease with Schneider National, Inc. Below, I have listed all of the companies for which I performed a safety sensitive function, or for which I took a drug and /or alcohol test, during the past three years. I hereby authorize the companies to furnish Schneider National, Inc. the following information concerning my drug and /or alcohol tests: 1. All verified positive drug test results during the past three years. 2. All alcohol tests with a result of 0.04 or higher alcohol concentration during the past three years. 3. All refusals to be tested (including verified adulterated or substituted drug test results) during the past three years. 4. Any violations of DOT agency drug and alcohol testing regulations or alcohol and controlled substance prohibitions during the past three years. 5. Any drug and/or alcohol rule violations provided by a previous employer during the past three years. 6. Documentation of successful completion of DOT return to duty requirements, to include SAP information and follow-up tests and/or documentation of non-completion or refusal of SAP referral during the past three years. 7. All testing violations subsequent to the successful completion of a SAP rehabilitation during the past three years. Company Name Dates worked (month/yr) Company Name Dates worked (month/yr) • I authorize Schneider (Employer/Lessor) its subsidiaries, affiliates or agents to use my Social Security number to investigate my background, character, general reputation, record of convictions, deferred prosecutions, and charges pending, and prior employment, by contacting my prior employers/lessors, references or any other individuals or agencies Employer considers necessary; • I authorize Employer/Lessor, my prior employers/lessors, educational institutions, references, and any other individuals or agencies contacted by Employer/Lessor to release any and all information they may have regarding me and absolve those parties who provide information requested from any and all liability related to their doing so; • I acknowledge that any employment/lease offered to me is at the will of Employer/Lessor and may be terminated by Employer/Lessor at any time, without cause. I understand my employment/lease is in reliance upon the fact that I live within the designated hiring region of my Operating Center; • I understand and agree that while I am receiving my training or traveling to/from the Schneider training facilities, I am not yet an employee/lessee of Schneider National, Inc. or its subsidiaries. Therefore, if I become injured or ill during the course of training, Schneider National, Inc., has no legal obligation to pay for my medical treatment. However, at its discretion, Schneider may pay a limited amount of any initial emergency medical treatment rendered to me. After that initial emergency treatment, I will make my own arrangement to pay for my medical treatment; • I acknowledge that I will be required and agree to submit to a physical examination and controlled substance and alcohol use testing as part of Employer’s/Lessor’s evaluation procedures and authorize release of my results to Employer/Lessor and Employer’s/Lessor’s use of those results in deciding whether I should be offered or continued in employment/lease; • I acknowledge that illegal alcohol or drug use during my employment/lease will be grounds for immediate termination without notice and without re course; • I certify by my signature that all entries and information on and in this application and all supplemental documents are true and complete to the best of my knowledge; • I agree that, if any of the information provided in this application and/or supplemental documents changes, whether before or after employment/lease, I will immediately provide Employer/Lessor with new and updated information; • I agree that not updating, or providing false, misleading or incomplete statements or data in this application and/or supplemental documents of, in connection with Employer’s/ Lessor’s evaluation of me as a candidate for employment/lease, is grounds for immediate termination of my employment/lease, regardless of when such information is discovered. I understand that Schneider (Employer/Lessor) must investigate the information I have provided by contacting all previous DOT regulated employers under which I was employed/leased in a safety-sensitive function that required alcohol and controlled substance testing within the previous three years from the date of this employment application. This investigation must be conducted in order to investigate my safety performance history, specified by FMCSA 49 CFR part 40 and 391. The investigation will include (at a minimum) general applicant identification and employment verification information as well as all DOT recordable accident information for the previous three years. Applicants have the following rights regarding the investigative information that will be provided to Schneider (Employer/Lessor) pursuant to FMCSA Reg 391.23 (i) (1): 1. The right to review information provided by previous employers. Applicants who have previous DOT regulated employment history in the preceding three years, and wish to review previous employer-provided investigative information must submit a written request to Schneider, ATTN: Regulatory Dept. (Employer/Lessor), within 30 days after being employed or of being notified of denial of employment. 2. The right to have errors in the information corrected by their previous employer and for that previous employer to re-send the corrected information to Schneider (Employer/Lessor). Applicants must send the request for the correction to the previous employer that provided the records to Schneider (Employer/Lessor). 3. The right to have a rebuttal statement attached to the alleged erroneous information, if the previous employer and the applicant cannot agree on the accuracy of the information. Applicant must send the rebuttal to the previous employer with instructions to include the rebuttal in that applicant’s safety performance history. By completing, submitting and signing this application, I hereby agree to all of the above. Print Name:_______________________________________________________________ Signature:_________________________________________________________________ Date: ______________________________________ Schneider National’s hiring/leasing criteria and application process may be changed at any time at its discretion without prior notice. (Please read and initial each policy) _____ Parking Policy: Drivers are expected to park their tractors at the Operating Center or other designated location whenever they are off duty unless approval to park elsewhere is obtained in advance from your Service Team Leader(STL). Drivers who are allowed to park at other locations are responsible for the security of the equipment and cargo and the starting of the tractor. If vehicles are parked inappropriately, the driver may be assessed a recovery charge of 75c per mile. During winter operation, plug in your vehicle when the vehicle is being parked for periods exceeding four hours. If parking away from the Operating Center, drivers must have permission from the property owner. _____ Pet Policy: No animals or pets of any type are permitted in equipment at any time. _____ King Pin Lock: Driver will sign King Pin Lock Agreement. The agreement reads as follows: • I have had the king pin lock program explained to me by my STL. • We have reviewed my park location agreement form. • I will use the king pin lock to prevent load theft when I park at any non-OC location. • I will not use the lock on any empty trailers. • I will follow the theft prevention steps for high value loads outlined in my reference guide. • I understand I will be charged $55 for the king pin lock in 4 weekly installments of $13.75. _____ Weapons Policy: No weapons of any type are permitted in the cab or side compartments of Schneider National owned or leased equipment or on company property, even if the driver is in possession of a valid permit. _____ Footwear Policy: Company driver associates must wear Schneider National provided and/or approved footwear at all times. This policy is effective July 1, 2003. This policy includes wearing proper footwear while working in and around equipment, or any time you are out of your vehicle. Approved footwear is defined as: • Non-skid sole • Leather uppers • Oil/water resistant • Sturdy construction • Ankle protection (6” or higher) Examples of non-approved footwear includes: open-toed shoes, tennis shoes, flip-flops, deck shoes, clogs, etc. Failure to comply may result in discipline up to and including the termination of employment. _____ Passenger Policy: Friends over the age of 18, or immediate family members over the age of 10, may participate. Eligible after six months of safe driving. _____ Union Free — Freedom to solve our problems together; • Building business partnerships • Shared problem solving • Treating associates in a fair and equitable manner • Recognizing outstanding performance Name: ________________________________________________ Date: __________________________________ EMERGENCY NOTIFICATION (Please enter spouse’s name if married) Name: __________________________________ Home Telephone# ______________________________ City/State: _______________________________ Relationship: __________________________________ Schneider National Program Policies 8 Fair Credit Reporting Act Disclosure In connection with your application for employment with Schneider National, Inc. and/or its affiliates and subsidiaries ("Schneider"), Schneider may obtain a consumer report and/or an investigative consumer report regarding your character, general reputation and mode of living, your motor vehicle record, criminal background record, credit history and/or other appropriate public record information from a consumer reporting agency, as those terms are defined in the Fair Credit Reporting Act and amendments ("FCRA"). These reports may also include the names and dates of your previous employers, reasons for the termination of your prior employment, work experience and any other type of information authorized under the FCRA or other applicable laws. Such reports may come from federal, state, local and/or any other agencies which contain and/or maintain such records. You may request in writing a complete disclosure of the nature and scope of the investigation to be performed. Name (print): ____________________________________________ Social Security Number: ______ / ______ / ______ Signature: ______________________________________________ Date: __________________________________________________ Fair Credit Reporting Act Authorization I hereby authorize Schneider to obtain consumer reports and/or investigative consumer reports, ("Consumer Reports") from any appropriate consumer reporting agency and understand that such Consumer Reports may be used by Schneider in the determination of whether or not to offer me employment. I also authorize any party or agency contacted by a consumer reporting agency to furnish the information listed in the Disclosure statement above. I understand that I have the right to make a request of such consumer reporting agencies, upon proper identification, of the nature and substance of all information in such files on me, including the source of information and recipients of any reports on me which have been previously furnished by the consumer reporting agencies within the two year period preceding my request. I hereby consent to allowing Schneider to obtain such Consumer Reports from any and all appropriate consumer reporting agencies and agree that such information maintained by such consumer reporting agencies will be supplied to Schneider and/or any other companies which subscribe to said services. I therefore authorize the procurement of said Consumer Reports by Schneider and, if hired by Schneider, understand that this authorization shall remain in my file and shall serve as on-going authorization for Schneider to procure additional consumer reports on at least an annual basis, or at any other time during my employment (this consent can be provided verbally as well). Name (print): ____________________________________________ Social Security Number: ______ / ______ / ______ Signature: ______________________________________________ Date: __________________________________________________ 9