Transport Solutions
APPLICATION FOR HIRE
And
RECORD FOLDER
Applicant: Read and sign before submitting this application:

The Age Discrimination Employment Act of 1967 prohibits discrimination on the basis of age with respect to individuals who are at least 40 but less than 70 years of age.

I understand that the information in this application will be used and that prior employers and carriers to who I have leased equipment will be contacted for purposes of investigation as required by Section 391.23 of the Federal Motor Carrier Safety Regulations
 
If you wish to print this application form instead of filling out the online version, click here to download our printer friendly version.
 
NAME OF APPLICANT     DATE    
First Name Middle Name Last Name
Phone Number ( ) -   Cell Phone Number ( ) -
Address City Province
Postal Code How long have you been living at this address?
 
LIST ADDRESSES FOR PAST THREE YEARS
 
Address City Province
Postal Code How long have you been living at this address?
 
Address City Province
Postal Code How long have you been living at this address?
 
 
Date of Birth (answer only if applying for driving position)
  Year(YYYY):   Month(MM):   Day(DD):
 
IN CASE OF EMERGENCY NOTIFY:
 
Name Address Phone
Relation  
 
Position Applied For Who refered You
PHYSICAL HISTORY
PLEASE DESCRIBE ANY POSITIONS, JOBS OR DUTIES FOR WHICH YOU SHOULD NOT BE CONSIDERED BECAUSE OF PHYSICAL, MEDICAL OR MENTAL DISABILITIES
 
HAVE YOU BEEN GRANTED A WAIVER UNDER SECTION 391.49 OF THE FEDERAL MOTOR CARRIER SAFETY REGULATIONS PERTAINING TO THE LOSS OF FOOT, LEG, HAND OR ARM? (FOR DRIVERS ONLY)
 
Driving Experience
CLASS OF EQUIPMENT TYPE OF EQUIPMENT
(VAN, TANK, FLAT, ETC.)		 DATES APPROX. NO. OF MILES
(TOTAL)
FROM TO
STRAIGHT TRUCK
TRACTOR AND SEMI-TRAILER
TWIN-TRAILERS
OTHER
 
LIST STATES AND PROVINCES OPERATED IN FOR LAST FIVE YEARS
EDUCATION
Highest Grade Completed:     High School:     College:  
LAST SCHOOL ATTENDED Name Address
 
SHOW SPECIAL COURSE OR TRAINING THAT WILL HELP YOU AS A DRIVER
 
Training School Attended Years Graduated
 
WHICH SAFE DRIVING AWARDS DO YOU HOLD AND FROM WHOM?
GENERAL
HAVE YOU EVER BEEN CHARGED WITH A CRIMINAL OFFENCE FOR WHICH YOU HAVE NOT RECEIVED A PARDON
HAVE YOU EVER WORKED FOR THIS COMPANY UNDER ANOTHER NAME