Driver Application Form

I am interested in

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Flatbed Van

First Name

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Last Name

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Email Address

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Address

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City

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Province/State

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Telephone

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Postal/Zip Code

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Social Security / Social Insurance Number

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Drivers License #

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Years of Driving Experience

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Any accidents in the past 5 years?

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Yes No

If yes, please give brief details

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Any traffic violations in the past 5 years?

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Yes No

If yes, please give brief details

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Have you ever had your license, permit or privilege to operate a motor vehicle denied, revoked or suspended?

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Yes No

If yes, please provide the reason(s)

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Any violations or conditions that would restrict you from operating in either the USA or Canada?

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Yes No

If yes, please explain:

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Is there anything you are aware of that may affect your ability to perform the duties of a professional transport driver?

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Yes No

Are you presently employed?

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Yes No

Please provide the three most recent employers information:

Company Name

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Contact:

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City

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Province/State:

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Phone

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Dates Employed(To-From)

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Company Name

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Contact

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City

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Province/State

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Phone

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Dates Employed(To-From)

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Company Name

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Contact

:

City

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Province/State

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Phone

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Dates Employed(To-From)

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Captcha

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By submitting this application you are agreeing to the following:

I certify that this application was completed by me and that all entries in it are true and complete. I authorize RSB LOGISTIC INC. to conduct a thorough background investigation in accordance with stat / provincial and federal law; and I hold my previous employers and persons named therin harmless of all liability from the release of said information. As a condition of my employment I agree to provide such additional information and complete any examinations as may be required to complete my employment file; including a medical examination and a substance abuse test. I understand that this application for employment in no way obligates RSB LOGISTIC INC. to employ me, the applicant.