Welcome!

Get On The Fast Track to a New Career !!!

 
 
Rocky Mtn Truck School
 
 
About Us
 
 
Contact Us
 
 
Site Map
 
 
Course Descriptions
 
 
 
To apply for school, print this application and mail back to us at
4510 Broadway SW, Albuquerque, NM 87105
or fax to (505) 888-5236.
 
STUDENT APPLICATION
 
Class Date you are applying for: ________________________
 
 
Last Name:________________________________   First Name: _____________________________
Address: __________________________________  Phone # :  ______________________________
              __________________________________    Cell # :    ______________________________
Veteran Status (optional) _____________________
 
Employment History:
Current/past employer: ___________________________  Phone #  ___________________________
       Current position or reason for leaving:  _______________________________________________
 
Emergency Contact:
Name: ____________________________________ Phone # :  _______________________________
Address: __________________________________  Relation:  _______________________________
              __________________________________
 
Reference (not related):
Name: ____________________________________ Phone # : ________________________________
Address: __________________________________
              __________________________________
 
Questionnaire:
The following questions will assist in identifying any possible area(s) that should be discussed regarding your future employment with a truck company.  (Note:  Questions are optional and are used for job placement/student financing purposes only.)  Please answer yes or no
 
1)  Is your employment/education history verifiable for the past three (3) years?                 _________
2)  Did you graduate high school/GED (informational only/not required for school).           _________
3)  Have you had your driver's license for at least one year?                                                  _________
4)  Do you have any disabilities that would prohibit you from driving? (Per DOT                _________
         guidelines) Explain: ________________________________________________
5)  Do you presently take any form of prescription medication? (Per DOT                            _________
        guidelines)  Explain: ________________________________________________
6)  Are you a US Citizen or Permanent Resident?                                                                    _________
7)  Has your driver's license been suspended or revoked within the past 3 years?                   _________
         If yes, date: ___________________________________________________
8) Have you ever been convicted of a DUI/DWI?                                                                     _________
         If yes, date: ___________________________________________________
9) Have you had any vehicular accident(s) in the past 3 years?                                                _________
         If yes & at fault, date: ___________________________________________
10) Have you received any driving/traffic tickets in the past 3 years?                                     _________
         If yes, what/date: _______________________________________________
11) Have you ever been convicted for possession, sale or use of an illegal drug or
         other controlled substance?                                                                                              _________
         If yes, date: ___________________________________________________
12)  Have you ever been convicted of a crime (misdemeanor or felony) or are any
         charges pending?                                                                                                              _________
         If yes, date: ___________________________________________________
13)  Do you have any travel restrictions?                                                                                 _________
14)  Do you have any medical/lifting restrictions?                                                                   _________
15)  Tuition will be paid by (circle one) cash, credit card, payment plan, other                        ________
 
I certify that all the information given above is correct and complete to the best of my knowledge.  I agree that my enrollment is based on the facts that I have given and any intentional misrepresentation on my part will constitute a release to the school for any liability that may be encountered by having acted on such facts.  I have read the above and understand it.  I hereby authorize Rocky Mountain Truck Driving School to investigate and verify facts claimed by me on this application.
 
Signature: ____________________________________    Date: _______________________________
Name (please print): ____________________________
 
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If you have questions or would like the student application/current brochure mailed to you, then please email us at rmtds1@aol.com and give us your complete name/address or provide your phone number if you would like to be contacted by phone.  Office phone numbers: (505) 888-5182 fax (505) 888-5236