Online Driver Application Form

 

Personal Data

    
Name  

     
Date  

 

  

 

    
Address          
City   Prov.   Postal        
Phone   Mobile Phone        
Fax   E.Mail         
Date available  Social Ins No   DOB        
Position Applied for Company DriverOwner/OperatorContractor's Driver      
Are you a Canadian's citizen ?    Yes   No If no are you authorized to work in Canada   Yes  No    
Have you ever worked for this company ?  YESNO If yes when ?         
Have you ever been convicted of a felony YESNO If yes explain:        
           
Previous addresses within the past three years:          
Address From   To         
Address From   To         
Address From   To         
Address From   To         
             

Driving Qualifications and Experience

    
Driver License (Licenses and permits held during the past 3 years):        
Province/State License Number Class Endorsements Expiration Date

Have you ever been denied a license, permit or privilege to operate a motor vehicle   YESNO

    
 If yes explain when and why           

Have any of your license ever been suspended or revoked   YESNO

        
If yes how long and why                       
Driving Experience:        

Class of equipment Truck/Tractor

From (mm/yyyy)       (mm/yyyy)

Approximate number of total miles
Straight Truck

Semi Trailer
Two Trailer
Three Trailer
Other

List all provinces and states operated in during the past 5 years 

List any safe Driving Awards you hold and from whom               

Accident record for the past 3 years: ( attach separate sheet if more space is needed)    
Date of accident Nature of Accident (head on, rear end upset etc.)  Location of accident Number of  Fatalities Number of injuries
Traffic conviction and forfeitures for the past 3 years (other than parking violation): attach separate sheet if more space is needed
Date  Location Charge Penalty

Employment History
             
Company Phone        
Address Supervisor        
Job title Salary($) Starting Ending        
Responsibility        
 From To Reason for leaving             
May we contact your previous supervisors for reference        YESNO        
Company Phone        
Address Supervisor           
Job title Salary($) Starting Ending          
Responsibility        
From To      
May we contact your previous supervisors for reference        YES  NO        
             
Company Phone                   
Address Supervisor           
Job title Salary($)   Starting Ending          
Responsibility        
From To      
May we contact your previous supervisors for reference         YES    NO        
Company Phone                    
Address Supervisor              
Job title Salary($)    Starting  Ending              
Responsibility        
From To          
May we contact your previous supervisors for reference       YES  NO        

EDUCATION
High School Address        
From To Did you graduate   YESNO Diploma        
                                               
College/university Address        
From To Did you graduate  YES  NO                Degree        
                                              
Other Address         
From To Did you graduate  YES NO Degree         
                                      
Are you presently studying          YES   NO Course  Where         
                                        

What are your future plans for additional education  

       
             

References
Please list three professional references :          
Full Name Relationship         
Company Phone                    
Address          
Full Name Relationship        
Company Phone                   
Address          
Full Name Relationship        
Company Phone                   
Address