L.A. Dalton Online Recruiting Application

Online Recruiting Application:

*First Name :

Middle Name :

*Last Name :

*Address1 :

Address 2 :

*City :

*Province / State :

*Postal / Zip Code :

*Email Address :

*Telephone :

Alternate Phone :

Fax :

Date of Birth :

Are you applying for a company driver position? :	Yes No
Are you applying for an Owner-Operator position? :	Yes No

Drivers licence number :

Issuing Province :

Date of Expiry :

When did you obtain your class 1A (AZ) :

How many years experience do you have driving for a Bulk? :
How many years experience do you have driving for Flatbeds? :
How many years experience do you have driving for a Tank? :
How many years experience do you have driving for a Van? :

Have you previously worked for LA Dalton?

Yes No

Are you currently admissible in the US?

Yes No

Do you require a waiver to enter the US? :

Yes No

In the past 3 years, how many moving violations have you had?
In the past 3 years how many accidents/violations have you had?
In the past 5 years, how many employers have you had?
Have you ever been denied a licence, permit or privilege to operate a motor vehicle?	Yes No
Has any licence, permit or privilege ever been suspended or revoked?	Yes No

If the answer is yes to either of these questions, please provide full details:

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