Recruiting Application

Thank you for your interest in employment at Cox Transfer.  If you have further questions following the completion and submission of your on-line application, you can e-mail us at or call us at 800-593-3590.

If you would prefer to download and completed the full driver application by hand, you can download it by clicking HERE. You can mail, fax, or e-mail the completed application to the following.

Attn: Recruiting
Cox Transfer Inc.
1065 West Center Street
Eureka, IL 61530
Secure Fax - (888) 811-2249


Fields in RED and an Asterisk are Required
*First Name
Middle Initial
*Last Name
*Home Phone Number  
Alternate Phone Number  
Cell Phone Number  
Fax Number  
Email Address  
*Street Address Line 1
Street Address Line 2
*State *Zip Code  
*Social Security #  
*Birth Date
Fields in RED and an Asterisk are Required
*CDL or License #  
*CDL or Driver License State
*CDL Expiration Date
*CDL Class
Haz-Mat Endorsement
*Interested In Opportunity
Over the Road Experience
*Years *Months
Have you been involved in an accident in the last three years?

Have you violated any motor vehicle laws or ordinances to which you were convicted or forfeited bond or collateral during the last three years?

Have you been involved in any DOT inspections in the last three years?

Have you had any denial, revocation, or suspension of any license, permit, or privilege to operate a motor vehicle?

Current Driving School Student
Driver School Name
Driver School City Driver School State
Graduation Date
PLEASE NOTE: Your application will NOT be considered unless every question in this section is answered and goes back for a period of TEN (10) YEARS.  Since we make every effort to contact previous employers for the purpose of investigating the applicant's background as required by CFR 49 391.23, the correct numbers of past employers are critical and all time must be accounted for including military service, self employment, and periods of unemployment.  Ask for a phone book or call information if you need to. 
*Company Name
City State
Position Held
Equipment Type
*Date Started *Date Ended
Reason For Leaving


This application form is intended for use in evaluating your qualifications for employment. This is not an employment contract.

It is agreed and understood that the Company or its agents may investigate the applicant’s background and the information provided in this application to ascertain or verify any and all information provided. Applicant releases employers and their employees from all liability for any damages on account of furnishing such information.

It is agreed and understood that subsequent to an initial offer of qualification and prior to commencing work, an applicant may be required to undergo further processing to determine suitability to perform the job. Such processing may include but is not limited to: a medical examination, drug test, performance test, written test and other such measurements of an applicant’s fitness to perform. It is agreed and understood that failure to satisfactorily meet all post-qualification may result in the withdrawal of the offer of qualification.

By clicking "I Accept" below, I certify that I have read and fully understand this release, that prior to clicking I was given an opportunity to ask questions and to have those questions answered to my satisfaction, and that I executed this release voluntarily and with the knowledge that the information being released could affect my being hired. I further certify that
all of the information that I have furnished on this form is true and complete, and that I have listed every company for which I have worked for the past ten years, and specifically as a driver during the past three years.  False or misleading statements on this application are grounds for terminating the application process or, if discovered after employment,  terminating employment.

*I ACCEPT (required)

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*Verification Characters

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