Application Form – Dalys Truck Driving School

ATTENTION: This application will not automatically enroll you in an online class. This application form is for students enrolling at an “on-site” classroom at Daly’s Truck Driving School, located at 2314 Peachtree Industrial Blvd. Buford, GA 30518. This website contains the Daly’s Truck Driving School material.

After completing this application form, you will be redirected to a payment portal. Before making a payment, please verify your start date at Daly’s Truck School. Please contact Stephanie @ 770-614-6022 to confirm your start date.

Application ( Current )

First Name *

Last Name *

Email *

Confirm Email *

Drivers License # *

Current Age *

Birthday *

Phone *

Address Line 1 *

Address Line 2

City *

State *

Zip Code *

Have you been convicited or charged with a DUI? *

Do you have Diabetes? *

Do you have high blood pressure? *

Do you have epilepsy? *

Do you have a heart condition? *

Have you ever had back surgery? *

Do you suffer from sleep apnea? *

Are you on any perscribed medications? *

Are you able to pass a drug screen? *

Is your vision 20/40 or better corrected? *

Do you have good use of your hands? *

Do you have good use of your legs? *

Do you have good hearing in both ears? *

Do you have a condition which causes fainting? *

Are you a United States citizen? *

Did you serve or are you currently in the military? *

Are you married? *

Any children? *

Do you have a work permit? *

Company Name #1

State that issued work permit

Number of years you've held work permit

Company Name #2

Number of years prior license was held #2

Do you have any criminal convictions? If so, please list charges & dates

Have you ever been arrested after the age of 18? Explain.

Signature *

Clear

Date *

*Please be aware: This website is for students enrolled in Class A or Class B attending Daly’s Truck Driving School – Buford, GA.
**Submission of this application is not to be intended or interpreted as a binding agreement between Daly’s an the applicant, however Daly’s may use this application in processing your enrollment with Daly’s Truck Driving School, Buford GA location. Once you submit the application, there will be additional paperwork you must sign in-person on or before your first day of class at Buford, Georgia.