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Double-D Transport
Employment Application Form
Name Date of Birth
Street Home Phone Number
City Cell Number
Province or State Fax Number
Postal Code or ZIP Email Address
       

Experience and Qualifications
License Number Endorsements
Tickets in last 3 Years Accidents in last 3 years
Driving School Attended  
Federal law requires that you be at least 21 years of age or older to be qualified to operate in interstate commerce.
Do you qualify?		 Yes No
Are you a Canadian Citizen? Yes No
If No, do you have a legal right to live and work in Canada? Yes No
Have you ever tested positive or refused to test on any pre-employment Drug or Alcohol test administered by an employer to which you applied for, but did not obtain employment during the past three years? Yes No

Employment History

Current/Most Recent Employer
*We will not contact your previous employers without your consent*
Current/Most recent Employer
Address
Phone
Contact Name
Position Held

Start Date

End Date
Are you presently employed? Yes No
May we contact this employer? Yes No

Second Last Employer
*We will not contact your previous employers without your consent*
Current/Most recent Employer
Address
Phone
Contact Name
Position Held

Start Date

End Date
May we contact this employer? Yes No

Third Last Employer
*We will not contact your any employers without your consent*
Current/Most recent Employer
Address
Phone
Contact Name
Position Held

Start Date

End Date
Are you presently employed? Yes No
May we contact this employer? Yes No

I certify that I personally completed this questionnaire and that all the information contained herein is true and correct.   I authorize
Double-D Transport Inc., to do a complete background investigation in accordance with provincial and federal laws.

 I authorize employers to release any information, including all information related to my alcohol and controlled substance testing and training records by the Federal Highway Administration (FHWA) 49 CFR Parts 391 or 382 to Double-D Transport Inc. and hold them harmless of all liability from the release of said information.  Please check this box if you have read and agree to these terms.

Yes No

Signed

 

Pease print and fax the completed form to 1-519-751-0729.

 

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Flatbed . Truckload . LTL . Specialized . Carrier . Logistics

Double-D Transport Inc. Brantford, Ontario, Canada

1-800-461-7822