CANAM Drivers - Clients Services

Online application

Professional vehicle operator application

Personal information

Name

First name

Middle nale

Telephone

Address

City

Province

How long?

Email

If less than 3 years at above address, please indicate previuos address below

Address

City

Province

How long?

SIN

Date of birth

Driver license #

How long

Do you have the legal right to enter into USA

Do you have the legal right to work in Canada?

In case of emergence, notify:

Name

Telephone (1)

Telephone (2)

Are you employed now?

If yes, with whom

Employement information and history

have you ever work for Canam in the past?

If yes, reason for leaving :

Provide all employers for past 10 years, starting with most recent

Name

Beginning date

Ending date

Telephone

Address

City

Province/State

Position

Reason for leaving

Type of freight

Supervisor

Name

Beginning date

Ending date

Telephone

Address

City

Province/State

Position

Reason for leaving

Type of freight

Supervisor

Name

Beginning date

Ending date

Telephone

Address

City

Province/State

Position

Reason for leaving

Type of freight

Supervisor

Name

Beginning date

Ending date

Telephone

Address

City

Province/State

Position

Reason for leaving

Type of freight

Supervisor

Name

Beginning date

Ending date

Telephone

Address

City

Province/State

Position

Reason for leaving

Type of freight

Supervisor

Name

Beginning date

Ending date

Telephone

Address

City

Province/State

Position

Reason for leaving

Type of freight

Supervisor

Name

Beginning date

Ending date

Telephone

Address

City

Province/State

Position

Reason for leaving

Type of freight

Supervisor

Name

Beginning date

Ending date

Telephone

Address

City

Province/State

Position

Reason for leaving

Type of freight

Supervisor

Name

Beginning date

Ending date

Telephone

Address

City

Province/State

Position

Reason for leaving

Type of freight

Supervisor

Name

Beginning date

Ending date

Telephone

Address

City

Province/State

Position

Reason for leaving

Type of freight

Supervisor

Education

Chosse highest grade/year completed

Elementary

High school:

College:

University:

Other:

Last school attended:

Name

City/province/State

Formation

Beginning date (mm/aaaa)

Ending date (mmm/aaaa)

Recognitions and awards

Awards

Date

Experience and qualification

Current valid license information

Province of issue

License no

Class Endorsements

Expiration

List all licenses held within the past 3 years

Province of issue

License no.

Class ÉEndorsements

Expiration

Have you ever been denied a license, permit or privilege to operate a motor vehicle?

Has any license, permit or privilege ever been suspended or revoked?

If the answer to either question above is yes, please provide details

Type of equipment

Approx number of miles

Straight truck:

Tractor and semi-trailer

Tractor and two trailers

Other

Accident / Traffic conviction history

List any accident / traffic convictions you have been involved in the past 5 years

Accidents

Date (month/ayear)

Description

At fault?

Traffic convictions

Date (month/year)

Description

Physical history

Do you have any physical condition or disability wich may limit your ability to perform the job applied for?

if yes, explain

Have you lost time or been unable to work within the past 3 years?

Have you ever been injured on the job?

Have you ever received worker's compensation?
When:

Are you willing to have a physical examination?

Documents required for the application

I certify that this form was completed by myself and this in good faith, and that all information given above is true. I authorize "Canam Driver" or its agents to conduct research or surveys on the information provided, my job, my financial credit, my criminal history, my statement of demerit points on driving, drugs, from my former from their employers or insurance, my insurance history, medical history or other can reach a decision regarding my employment.

If the decision to hire me is positive, the information on this form will be kept and may be re-audited or reported and used at any time during my employment during the contract period or after the period, if necessity. Generally, a survey of medical history will be made only if and only if a conditional offer of employment was extended for more than a year.

Hereby authorize employers, schools, health insurance organizations and others to provide information regarding this application. In order to gather this information, I agree to provide the following information which may be required by the implementing agencies and other entities to identify from these data. This is confidential and will not be used for any other purpose. I understand that the information I provide regarding current employers and / or earlier can be used and that these employers will be contacted in order to review my work history, as well as CFR391.23 49 (d) and ( e). I acknowledge that I have the right:

View / review information provided by current employers and / or precedents;
Accept the principle that errors in the information be corrected by previous employers and that they send the corrected information to potential employers
Link a declaration of refusal to any data corrections, if the former employer and I do not agree on the corrections.
List of documents to bring during the interview:

I have read and undestood those rules