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NEW WAY TRUCKING LTD./1063915 ALBERTA LTD.

DRIVER APPLICATION FOR EMPLOYMENT


INSTRUCTIONS:

POSITION APPLIED FOR: DATE OF APPLICATION:    
FOR OWNER OPERATORS:
NAME OF CORPORATION WCB #
VEHICLE MAKE & YEAR VEHICLE MILLAGE


LEGAL STATUS IN CANADA?

FULL NAME

CURRENT ADDRESS

CONTACT INFO

DRIVER LICENCE PROVINCE / CLASS / ENDORSEMENTS / CONDITIONS? WHEN DID YOU GOT YOUR FIRST CLASS 1 / AZ LICENCE?
DRIVER LICENCE NO.

HOW MANY YEARS OF EXPERIENCE DO YOU HAVE DRIVING A TRACTOR-TRAILER IN?

HOW MANY YEARS OF EXPERIENCE DO YOU HAVE WITH THE FOLLOWING EQUIPMENTS?

1. DO YOU HOLD A VALID PASSPORT?   YES       NO 7. HAVE YOU EVER BEEN DENIED A DRIVER LICENCE?   YES       NO
2. ARE YOU ABLE TO LEGALLY ENTER IN THE US?   YES       NO 8. HAS YOUR ANY DRIVER LICENCE/PERMIT BEEN SUSPENDED OR REVOKED?   YES       NO
3. ARE YOU ELIGIBLE TO QUALIFY FOR A FAST CARD?   YES       NO 9. HAVE YOU BEEN CONVICTED OF ANY CRIME?   YES       NO
4. WOULD YOU BE WILLING TO TAKE A PHYSICAL/ MEDICAL EXAM/ DRUG & ALCOHOL TEST?   YES       NO 10. DO YOU HAVE ANY MEDICAL CONDITION (CONVULSIVE DISORDER, EPILEPSY, FAINTING, OR HEART DISEASE ETC.)?   YES       NO
5. ARE YOU ABLE TO LIFT 50 LBS OF WEIGHT?   YES       NO 11. HAVE YOU EVER BEEN INJURED ON THE JOB?   YES       NO
6. HAVE YOU PREVIOUSLY WORKED FOR NEW WAY?   YES       NO 12. HAVE YOU EVER FILLED WCB CLAIM?    

IF YOUR ANSWER IS 'YES' TO ANY OF THE QUESTION # 7 TO 12, PLEASE EXPLAIN/SPECIFY THE DATE AND REASON. PLEASE ALSO EXPLAIN IF THERE ANY REASON YOU MAY NOT BE ABLE TO PERFORM YOYR DUTIES. IF YOU ARE AN EX-EMPLOYEE OF NEW WAY, PLEASE MENTION DURATION OF EMPLOYMENT AND REASON FOR LEAVING.

DO YOU HAVE ANY MOVING VIOLATIONS THAT ARE NOT LISTED ON YOUR DRIVER ABSTRACT?
IF YES, PLEASE SPECIFY:

RECORD ALL TRAFFIC CONVICTIONS & FINES FOR THE PAST 3 YEARS (OTHER THAN PARKING VIOLATIONS) INCLUDING ANY THAT MAY NOT BE LISTED ON YOUR ABSTRACT. IF NONE, INDICATE NONE

DATE LOCATION CHARGE / CONVICTION PENALTY

RECORD ALL ACCIDENTS (Preventable / Non Preventable) FOR THE PAST THREE YEARS INCLUDING NON COMMERCIAL VEHICLES, INCLUDING ANY THAT MAY NOT BE LISTED ON YOUR ABSTRACT. IF NONE, INDICATE NONE.

DATE LOCATION NATURE OF ACCIDENT (HEAD ON/REAR END) INJURY / FATAL / PROPERTY DAMAGE

LIST EACH DRIVER LICENSE held in last three years?

JURISDICTION / PROVINCE LICENCE # LICENCE CLASS / ENDORSEMENT & CONDITIONS ISSUE DATE EXPIRY DATE

LIST THREE (3) PERSONAL REFERENCES, OTHER THAN FAMILY MEMBERS, WHO HAVE KNOWLEDGE OF YOUR SAFETY HABITS.

NAME COLLEAGUE / FRIEND KNOWN SINCE CONTACT NO


EMPLOYMENT HISTORY

All applicants must provide the following information on all employers during the PRECEDING 10 YEARS. List employers/work/education/unemployment history in reverse order, starting with the most recent. There SHOULD BE NO GAP BETWEEN THE DATES. Periods of unemployment / school / colleges also should be recorded. Use additional page (s) if required.


FROM: TO:
NAME OF THE EMPLOYER CITY / PROVINCE
CONTACT NO CONTACT PERSON
POSITION PAY RATE
DRIVING EXPERIENCE
EQUIPMENT OPERATED
REASON FOR LEAVING

FROM: TO:
NAME OF THE EMPLOYER CITY / PROVINCE
CONTACT NO CONTACT PERSON
POSITION PAY RATE
DRIVING EXPERIENCE
EQUIPMENT OPERATED
REASON FOR LEAVING

FROM: TO:
NAME OF THE EMPLOYER CITY / PROVINCE
CONTACT NO CONTACT PERSON
POSITION PAY RATE
DRIVING EXPERIENCE
EQUIPMENT OPERATED
REASON FOR LEAVING

FROM: TO:
NAME OF THE EMPLOYER CITY / PROVINCE
CONTACT NO CONTACT PERSON
POSITION PAY RATE
DRIVING EXPERIENCE
EQUIPMENT OPERATED
REASON FOR LEAVING


PLEASE READ CAREFULLY BEFORE SIGNING


I certify that all information provided in this employment application is true and complete.

I understand that any false or inaccurate information or misrepresentation of fact or omission of information requested, as stated or implied, given in my application, interview(s), or any other employment form or supporting document may disqualify me from further consideration for employment and may result in my dismissal if discovered at a later date. I authorize the investigation of any or all statements, content contained in this application. I hereby authorize, listed or not, all individuals and organizations named or referred to in this application to provide new way trucking all information including medical, financial and all other information deemed necessary to judge my capability to do the work for which I am applying. I hereby release such individuals, organizations and New Way Trucking from any and all liability for any claim or damage resulting therefrom. I understand that I may be required to pass a pre-employment drug screening, and if hired, I will be subject to New Way Trucking’s, drug and alcohol testing policy during my employment. I hereby consent to a substance test as a condition of employment, as required. I understand that if I am extended an offer of employment it may be contingent upon my successful completion of various examinations, training and orientation. I understand that, if hired, I will be required to provide documentation of both my identity and employment eligibility in Canada. I understand that, if hired, my employment will be subject to various guidelines, rules and regulations of New Way Trucking as stated in any policy and procedure manual or other communications to employees. I further understand that New Way Trucking policies and procedures are subject to modification without notice.

I UNDERSTAND THAT THIS APPLICATION, VERBAL STATEMENTS BY MANAGEMENT, OR SUBSEQUENT EMPLOYMENT DOES NOT CREATE AN EXPRESS OR IMPLIED CONTRACT OF EMPLOYMENT NOR GUARANTEE EMPLOYMENT FOR ANY DEFINITE PERIOD OF TIME. ONLY THE PRESIDENT OR AN AUTHORIZED REPERSENTATIVE OF THE ORGANIZATION HAS THE AUTHORITY TO ENTER INTO AN AGREEMENT OF EMPLOYMENT FOR ANY SPECIFIED PERIOD AND SUCH AGREEMENT MUST BE IN WRITING, SIGNED BY THE PRESIDENT OR AN AUTHORIZED REPERSENTATIVE AND THE EMPLOYEE. IF EMPLOYED, I UNDERSTAND THAT I HAVE BEEN HIRED AT THE WILL OF THE EMPLOYER. I UNDERSTAND THAT FOR A PERIOD OF 90 DAYS MY EMPLOYMENT WILL BE DEEMED PROBATIONARY AND MAY BE TERMINATED AT ANY TIME, WITH OR WITHOUT REASON AND WITH OR WITHOUT NOTICE.

I have read, understand, and by my signature consent to these statements.


APPLICANT NAME:
DATE:


THANK YOU

FOR APPLYING WITH NEW WAY TRUCKING / TPX


In compliance with Federal equal employment opportunity laws, qualified applicants are considered for all positions without regard to race, colour, religion, sex, national origin, age, marital status, or non-job related disability.


DRIVER'S CONSENT FOR REFERENCE CHECK
DRIVER NAME DRIVER LICENCE #
PREVIOUS EMPLOYER

I hereby authorize New-Way Trucking Ltd / 1063915 Alberta Ltd to contract my previous employer (s) in order to obtain following information. I release my previous employer (s) from any and all liabilities which may result from furnishing such information. I fully understand the repercussion of such consent, and do hereby give and affirm my consent to obtain all required information.


DRIVER/APPLICANT SIGNATURE: DATE



REFERENCE CHECK / EMPLOYMENT VERIFICATION

(TO BE FILLED BY THE PREVIOUS EMPLOYER)



NAME OF THE EMPLOYER
NAME OF THE EMLOYEE / DRIVER
EMPLOYED FROM EMPLOYED TO
DRIVING EXPERIENCE
EQUIPMENT OPERATED
HPW DO YPU RATE THIS DRIVER?
POOR AVERAGE GOOD
OVERALL RATING
DRIVING
PAPERWORK/LOG BOOK
EQUIPMENT CARE
RELIABILITY/DISPATCH
REASON FOR LEAVING?
ELIGIBLE FOR RE-HIRE? REASON
WCB CLAIM DUE TO INJURY? IF YES, DETAILS:
DID THE DRIVER PARTICIPATED IN A RENDOM DRUG & ALCOHOL TEST? HAS THE DRIVER EVER TESTED POSITIVE OR REFUSED TEST FOR CONTROLLED SUBSTANCE OR ALCOHOL?
LIST OF DRIVER'S ACCIDENTS
DATE LOCATION DETAILS
LIST OF VIOLATION TICKETS
DATE LOCATION DETAILS


INFORMATION GIVEN BY:

NAME: DESIGNATION: DATE:







PLEASE FAX THE COMPLETE INFORMATION AT (587) 316-2101
OR EMAIL AT cgysafety@newwaytrucking.ca

DRIVER HIRING

Send Your Resume at hr@newwaytrucking.ca