TRANSPORTATION

Recruiting Specialists

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Application Form

Current Opportunities

Call: 1 (800) 661-0377

Submit Application

Date:

Name:

Address:

City/Province/Postal Code:

Emergency Contact Name:

Phone Number:

Emergency Phone Number:

Email:

Cell Phone Number:

Age:

Date of Birth:

Social Insurance Number:

Position Applied For:

Driving Preference:

Do you have the legal right to work in Canada?	Yes No
Has your license ever been revoked or suspended?	Yes No
Have you ever been denied a license, permit or privelege to operate a motor vehicle?	Yes No
Are you currently employed?	Yes No
Married?	Yes	No

Who Referred You?

Rate of pay expected:

Drivers License

License #	Type	Expire Date

Three Years Previous Addresses

Address	From	To

Education

Through what grade did you complete?
Name of Grade School:
Name of High School:
Name of College:
Name of Post-Graduate College:

Past Employment

Present or Last Employer

From:			Position Held:
To:			Reason for Leaving:

Name:
Address:
Phone:

Previous Employer

From:			Position Held:
To:			Reason for Leaving:

Name:
Address:
Phone:

Previous Employer

From:			Position Held:
To:			Reason for Leaving:

Name:
Address:
Phone:

Previous Employer

From:			Position Held:
To:			Reason for Leaving:

Name:
Address:
Phone:

Driving Experience

		Dates Operated
Straight Truck:	Miles of Experience:	From To:
Tractor and Semi-Trailer:	Miles of Experience:	From To:
Tractor-two Trailers (Type A, B, C):	Miles of Experience:	From To:
Other:	Miles of Experience:	From To:

List Provinces/states operated in for the last five years:
List special courses/training completed:
List any driving awards you hold:

Accident Record

Date of	Nature of Accident	Location of	# of	# of People
Accident	(Head-on, rearend, etc)	Accident	Fatalities	Injured

Traffic Convictions and Forfeitures for the last three years

Date	Location	Charge	Penalty

Personal References

Name	Address	Phone

Other Questions

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?
Have you ever been convicted of a felony?
If you answered yes to any of the above three questions, please explain:

Thank you for filling out the online application. Now please read the disclaimer then click on the *Submit Job Application* button to complete the application.

Disclaimer

It is agreed and understood that any misrepresentation given on this application for qualification shall be considered an act of dishonesty.

I give KEE and its agents or representatives the right to investigate all references and to secure additional information about my employment background. I hereby release from all liability for damages the motor carrier and its agents or representatives for seeking such information and all other persons, corporations or organizations for furnishing such information.

I agree to furnish such additional information and complete such examinations as may be required to complete my employment file.

It is agreed and understood that this is an application for qualification in no way obligates the motor carrier to employ me.

It is agreed and understood that if qualified to operate motor carrier equipment, I may be on a probationary period, during which I may be disqualified without recourse.

By clicking on the submit button, I certify that this application was completed by me, and that all entries on it and information in it are true and complete to the best of my knowledge.