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Commercial Driver's Application
In compliance with Federal, State and Provincial equal opportunity laws, qualified applicants are considered for all positions without regard to race, colour, religion, sex, national origin, age, marital status, or the presence of a non-job related medical condition or handicap.

Date of Application:     Position(s) Applied For:  

Name:     Social Security #:  
  Last First Middle

Address:  
  Street City Prov/State Postal Code/ZIP

Phone #:     Cell #:     Pager #:  

EMail Address:  

Prior Address 1:     How Long?  
  Street City PC/ZIP
Prior Address 2:     How Long?  
  Street City PC/ZIP

Date of Birth:  

Are you able to cross International Borders without restriction?:   Yes   No

Do you have the legal right to work in Canada?   Yes   No       or the USA? Yes   No

Are you FAST Approved?   Yes   No               Canada or US Based Driver

As a condition of employment would you be willing to take a physical examination?   Yes   No

Have you worked for this company before?   Yes   No
If Yes - When did you work for us? From     to  
Position:     Reason for Leaving:  

Are you now Employed? Yes   No
If No - How long since leaving last employment?     Who referred you?  

Employment History

All driver applicants wishing to drive in interstate/intrastate commerce must provide the following information on all previous employers for whom the applicant operated a commercial vehicle during the preceding 7 years.
Past Employer 1
Name: From:
Address: To:
City/State: Position:
Contact/Phone: Reason for Leaving:
Past Employer 2
Name: From:
Address: To:
City/State: Position:
Contact/Phone: Reason for Leaving:
Past Employer 3
Name: From:
Address: To:
City/State: Position:
Contact/Phone: Reason for Leaving:
Past Employer 4
Name: From:
Address: To:
City/State: Position:
Contact/Phone: Reason for Leaving:

Accident Record
Have you had any accidents in the last 5 years?   Yes   No
If Yes -
Dates Description (Head on, Rear end, etc.) Injuries/Fatalities

Traffic Convictions
Have you had any Traffic Convictions in the last 3 years? (other than parking violations)   Yes   No
If Yes -
Location Date Charge Penalty

Experience / Qualifications / Drivers Licence
State/Prov Licence # Type Expiration Date

Has your license to operate a motor vehicle ever been denied, revoked or suspended? Yes   No
If Yes - Give Details

Class Type (Van, Tank, etc) Date From Date To # of Miles Total
Straight Truck
Tractor Trailer
School Bus/Coach
Other

List all states you've operated in for the last 5 years:

List additional courses, training, experience that will help you as a driver:

Do you hold any Safe Driving Awards and from Whom?

For your application to be considered, you MUST print and return the authorization form