Job Application for

First Name

Last Name

SIN

DL#

Date of Birth

Current Address

City

Postal Code

Province

Country

Contact#

How long? (Enter numbers only)

Please provide previous address details if none, write None

Previous Address 1

How long? (Enter numbers only)

Previous Address 2

How long? (Enter numbers only)

Previous Address 3

How long? (Enter numbers only)

Total years of residence

Do you have work right for working in Canada?:

Can you provide proof of age?

Please provide previous employment details if none, write None

Previously Worked

Date of Leaving (yyyy-mm-dd)

Where

Reason of Leaving

Pay Rate

Position

Are you employed now?

If not, How Long?

Referred by

Have you ever been bonded?

Name of bonding company

Have you ever been convicted of a felony?

If yes, explain

Is there any reason you might be unable to perform the functions of the job which you have applied for [as described In the attached job description]?

If yes, explain

Are you a FAST approved driver?

FAST Card#

Expiry Date (yyyy-mm-dd)

If no, are you willing to apply or not

Please provide 10 years employment history details if none, write None

Employment History - 1

All drivers applicants to drive in interstate commerce must provide the following information on all employers during the preceding 3 years. List complete mailing address, street number, city, province and postal code. Applicants to drive a commercial motor vehicle in Interstate or interstate commerce shall also provide an additional 7 years' information on those employers for whom the applicant operates such a vehicle. (Note: List employers in reverse order starting with the most recent. Add another sheet as necessary.

Employer Name

Date From (yyyy-mm-dd)

Date To (yyyy-mm-dd)

Position Held

Address

City

Province

Postal Code

Salary Wage

Contact Person

Phone Number

Reason for Leaving

Driving Experience [Years] (Enter numbers only)

Where you subject to the FMCSRs** while employed?

Was your job designated as a Safety-Sensitive function in any Dot-Regulated mode subject to the drug and alcohol testing requirements of 49 CFR part 40?

Employment History - 2

Employer Name

Date From (yyyy-mm-dd)

Date To (yyyy-mm-dd)

Address

Position Held

City

Province

Postal Code

Salary Wage

Contact Person

Phone Number

Reason for Leaving

Driving Experience [Years] (Enter numbers only)

Where you subject to the FMCSRs** while employed?

Was your job designated as a Safety-Sensitive function in any Dot-Regulated mode subject to the drug and alcohol testing requirements of 49 CFR part 40?

Employment History - 3

Employer Name

Date From (yyyy-mm-dd)

Date To (yyyy-mm-dd)

Address

Position Held

City

Province

Postal Code

Salary Wage

Contact Person

Phone Number

Reason for Leaving

Driving Experience [Years] (Enter numbers only)

Where you subject to the FMCSRs** while employed?

Was your job designated as a Safety-Sensitive function in any Dot-Regulated mode subject to the drug and alcohol testing requirements of 49 CFR part 40?

Employment History - 4

Employer Name

Date From (yyyy-mm-dd)

Date To (yyyy-mm-dd)

Address

Position Held

City

Province

Postal Code

Salary Wage

Contact Person

Phone Number

Reason for Leaving

Driving Experience [Years] (Enter numbers only)

Where you subject to the FMCSRs** while employed?

Was your job designated as a Safety-Sensitive function in any Dot-Regulated mode subject to the drug and alcohol testing requirements of 49 CFR part 40?

Employment History - 5

Employer Name

Date From (yyyy-mm-dd)

Date To (yyyy-mm-dd)

Address

Position Held

City

Province

Postal Code

Salary Wage

Contact Person

Phone Number

Reason for Leaving

Driving Experience [Years] (Enter numbers only)

Total Driving Experience

Where you subject to the FMCSRs** while employed?

Was your job designated as a Safety-Sensitive function in any Dot-Regulated mode subject to the drug and alcohol testing requirements of 49 CFR part 40?

*Includes vehicles having a GVWR of 26,001 lbs. or more, vehicles designed to transport 16 or more passengers(Including the driver) or any size vehicle used to transport hazardous materials in a quantity requiring placardlng,

*The Federal Motor Carrier Safety Regulations (FMCSRs) apply to anyone operating a motor vehicle on a hlghway in Interstate commerce to transport passengers or property when the vehlcle: 1. weighs or has a GVWR of 10,001 pounds or more. 2. Is designed or used to transport more than 8 passengers (Including the driver), or 3. ls of any size and is used to transport hazardous materials in a quantity requiring placarding.

Accident record for past 3 years or more (attach sheet if more sapce is needed)if none, write None

Accident History - 1

Accident Date (yyyy-mm-dd)

Nature of Accident

Fatalities

Injuries

Hazardous Material Spill

Accident History - 2

Accident Date (yyyy-mm-dd)

Nature of Accident

Fatalities

Injuries

Hazardous Material Spill

Accident History - 3

Accident Date (yyyy-mm-dd)

Nature of Accident

Fatalities

Injuries

Hazardous Material Spill

Traffic convictions and forfeitures for the past 3 years (other than parking violations)if none, write None

Traffic Convictions History - 1

Location

Date (yyyy-mm-dd)

Charge

Penalty

Traffic Convictions History - 2

Location

Date (yyyy-mm-dd)

Charge

Penalty

Traffic Convictions History - 3

Location

Date (yyyy-mm-dd)

Charge

Penalty

Experience and qualifications - Driver

Province

License Number

License Type

Expiration Date (yyyy-mm-dd)

Province

License Number

License Type

Expiration Date (yyyy-mm-dd)

A. Have you ever been denied a license, permit or privilege to operate a motor vehlcle?

B. Have any license, permit or privilege ever been suspended or revoked?

If the answer to either question A or question B is yes, please give details

Class of Equipment

Type of Equipment

Date from (yyyy-mm)

Date To (yyyy-mm)

Approx. No. of Miles (Total)

Class of Equipment

Type of Equipment

Date from (yyyy-mm)

Date To (yyyy-mm)

Approx. No. of Miles (Total)

Class of Equipment

Type of Equipment

Date from (yyyy-mm)

Date To (yyyy-mm)

Approx. No. of Miles (Total)

Class of Equipment

Type of Equipment

Date from (yyyy-mm)

Date To (yyyy-mm)

Approx. No. of Miles (Total)

Class of Equipment

Type of Equipment

Date from (yyyy-mm)

Date To (yyyy-mm)

Approx. No. of Miles (Total)

Class of Equipment

Type of Equipment

Date from (yyyy-mm)

Date To (yyyy-mm)

Approx. No. of Miles (Total)

List provinces & states operated in last five years

Show special courses or training that will help you as a driver

Which safe driving awards do you hold and from whom

Experience and qualifications - Others

Show any trucking, transportation or other experience that may help your work for this company

List courses and training other than as shown elsewhere in this application

List special equipment or technical materials you can work with (other than those already shown)

Education

Highest Grade Completed (Enter 1-8)

High School (Enter 1-4)

College (Enter 1-4)

Last School Attended

Terms of use

Driver's Signature

Driver's Initials

I acknowledge that I have read, understand, and agree to the Terms of Use for this application

Reset

Driver Job Application

Please provide previous address details if none, write None

Please provide previous employment details if none, write None

Please provide 10 years employment history details if none, write None

Employment History - 1

Employment History - 2

Employment History - 3

Employment History - 4

Employment History - 5

Accident record for past 3 years or more (attach sheet if more sapce is needed)if none, write None

Accident History - 1

Accident History - 2

Accident History - 3

Traffic convictions and forfeitures for the past 3 years (other than parking violations)if none, write None

Traffic Convictions History - 1

Traffic Convictions History - 2

Traffic Convictions History - 3

Experience and qualifications - Driver

Experience and qualifications - Others

Education

Terms of use