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Online Owner Operator / Driver Employment Application.

All areas of application must be completed. Please have available Current Abstract, copy of CVOR (if available).
APPLYING FOR:	Owner Operator Driver
GENERAL INFORMATION:
Date:	mm dd yyyy
Name:	First, Initial, Last
Address:
City:
Province:
Postal Code:
Phone: (incl. area code)	home cell
Fax: (incl. area code)
Email Address:
SIN #:
Date of Birth:	mm/dd/yyyy
License & Driver Information:
Driver License #:
D.L. Type:
D.L. Prov/State:
D.L. Expiry Date:	mm/dd/yyyy
Has any license, permit or privledge ever been suspended or revoked?	yes no
If yes, please provide date and full details:
Are you able to enter the U.S.A.?	yes no
Are you part of the CDRP: (Commercial Driver Registration Program)	yes no
Driver Experience:
Tractor/Trailer:	years: approx. miles:
Straight Truck:	years: approx. miles:
Other:	years: approx. miles:
Number of Accidents in the last 3 years:
List accident details: (if applicable)	Date Location Nature Fatality Y/N Injury Y/N Property Damage Y/N
Traffic Convictions in the last 3 years: (excluding parking fines)
Please list Traffic Convictions: (if applicable)	Date Location Charge Penalty
Work History:
Have you previously worked for Magnum?	Yes No If yes, From (mm/yyyy) to
Current or Last Employer:
Company Name:
Address:
City:
Postal Code:
Phone (incl. area code):
Contact Name:
Date Employed:	From (mm/yyyy) to
Driving Experience:	Canada USA Local
Reason for Leaving:
Previous Employer 1:
Company Name:
Address:
City:
Postal Code:
Phone (incl. area code):
Contact Name:
Date Employed:	From (mm/yyyy) to
Driving Experience:	Canada USA Local
Reason for Leaving:
Previous Employer 2:
Company Name:
Address:
City:
Postal Code:
Phone (incl. area code):
Contact Name:
Date Employed:	From (mm/yyyy) to
Driving Experience:	Canada USA Local
Reason for Leaving:
Education:
Highest Grade Completed:	(select one) 1 2 3 4 5 6 7 8 9 10 11 12 13
College/University:	(select one) 1 2 3 4
Describe any other courses, training skills:
Personal References:
Reference 1:	Name & Occupation: Address: Phone #:
Reference 2:	Name & Occupation: Address: Phone #:
Person To Be Notified In Case Of Accident Or Emergency:	Name & Address:   Phone #:
PLEASE READ CAREFULLY; APPLICANTS CERTIFICATION & AGREEMENT I hereby certify that the facts set forth in the above employment application are true and complete to the best of my knowledge. I understand that if employed, falsified statements on this application shall be considered sufficient cause for dismissal. I hereby authorize an individual, company, or institution to furnish this company with any information he/she or it may have concerning me on record or otherwise, and do hereby release such individual company or institution and all individuals connected herewith from and any and all liabilities.
Applicant Authorization: Name: Dated:
THANK YOU FOR APPLYING WITH MAGNUM TRANSPORT INC. WE PROVIDE TRANSPORTATION, WE DELIVER DEPENDABILITY.