Please fill out form , print out and fax to (416) 352-5939
Driver's application for employment
Posion Applied for
d/m/y
Date
Name
Social Insurance
Address Address
City Prov.
Postal Code Phone
Birth date Can you provide proof of age
Are you employed
Is there any reason you might be unable to perform the functoins of the job for which you have applied (as described in the attached description)
All drivers applicants to drive must provide the following info on all employment during the last 3 years. Applicants to drive a commercial motor vehicle* in intraprovince commerce shall also provide an additional 7 years info on those employers for whom the applicant operated such vehicle.(NOTE list employers in reverse order starring with the most resent
2255B Queen St.East
Box 313, Toronto Ontario
Ontario, M4E 1G3
Phone: (416) 690-4190
Fax: (416) 352-5939
Email us
Employer Employer
Name Name
Address Address
Address Address
City Prov City Prov
Contact phone Contact phone
Employer
Employer
Name
Name
Address
Address
Address
Address
City Prov
City Prov
Contact phone
Contact phone
Accident Record
Last Accident date Head-On Rear-End Upset Fatalities Injuries
Accident date Head-On Rear-End Upset Fatalities Injuries
Traffic Convictions for the past 3 years ( no parking violations)
Location Date Charge Charge
Location Charge Charge
Date
Education Have you ever been denied a Licence
click on highest grade completed Has any licence permit or privillege ever been suspended
Driving Experience
Class of Equipment From To
Class of Equipment
Total miles
Areas of operation Courses and Safty Awards
To Be Read And Signed by Applicant

This certifies that this application was completed by me and all entries on it and information in it are true and complete to the best of my knowledge I authorize you to make such investigations of my personal, employment, financial or medical history and other related matters as may be necessary in arriving at an employment decision. (Generally, inquiries regarding medical history will be made only if and after a conditional offer of employment has been extended.) I herby release employers, schools, health care providers and other persons from all liability in responding to inquiries and releasing informationin connection with my application. In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I also understand, that I am required to abide by all rules and regulations of the company

Applicants Signature
Date