Application for Employment - Driver Positions
Vitran Express is an equal opportunity employer.
Applicants are considered for employment without regard to race, religion, sex, age, disability, citizenship status, or any other basis prohibited by law, unless such basis constitutes a bona fide occupational qualification.
Vitran Express will comply with its legal obligation to provide reasonable accommodation to qualified individuals with disabilities.

All required fields are noted in Red and must be completed prior to submitting this application !!!
Personal Information
Date of Application: 3/9/2010
First Name:
Middle Name:
Last Name:
Primary Phone: - -
Other Phone: - -
Email Address:

Current and Previous Addresses
Current Address Information
Street Address:
Apartment or Suite Number:
City:
State:
Zip Code: -

If you have lived at the residence listed above for less than three years, please use the textboxes below for an additional residence.
If more space is needed, please use the "Additional Information" textbox located at the bottom of this section.
Previous Address Information
Street Address:
Apartment or Suite Number:
City:
State:
Zip Code: -
Additional Information:

Employment Opportunity Information
Position Applying for:
Location You Could Work From:
Desired Job Status:
Referred By:

How Did You Learn of This Employment Opportunity?
Advertisement (Source):
Relative (Full Name):
Friend (Full Name):
Other:
Rate of Pay Expected:

Have You Worked for This Company Before?

Do You Have Any Relatives Employed by Vitran Express?
Are You Currently Employed?

Education Information
Level of Education:
Any Additional Education:
Last School Attended:
Address of School:
Phone Number: - -

Legal Information
Have You Ever Been Convicted of or Pled Guilty to a Felony?
Are You a Citizen of the United States or an Alien Legally Entitled to Work in the Position(s) for Which You Have Applied?
For the Purpose of Verifying Past Employment and/or Schools Attended, Please Indicate Any Other Names You May Have Used:

Employment Information
Begining with Your Present or Most Recent Job, Please List All Your Employment Experience for the Last Ten Years.
You May Include Military Assignments that Reflect Your Qualifications for Employment.
Use the "Additional Employment Information" Textbox Located at the Bottom of this Section if Necessary.

Employer:
Street Address:
Building or Suite Number:
City:
State:
Zip Code: -
Phone Number: - -
Job Title:
Supervisor:
Start Date:



End Date:



Starting Pay Rate:
 Ending Pay Rate:
Duties:
Reason for Leaving:
Can We Contact This Employer?:


Employer:
Street Address:
Building or Suite Number:
City:
State:
Zip Code: -
Phone Number: - -
Job Title:
Supervisor:
Start Date:



End Date:



Starting Pay Rate:
 Ending Pay Rate:
Duties:
Reason for Leaving:
Can We Contact This Employer?:

Additional Employment Information:
Have You Ever Been Discharged or Asked to Resign From Any Position?

Driver Experience & Qualifications

Driver's Licenses Held in the Past Three Years Must be Shown
State License Number Class Endorsement(s) Expiration Date

Have You Ever Been Denied a License, Permit or Privilege to Operate a Motor Vehicle?
Have You Had Any License, Permit or Privilige Suspended or Revoked?
Have You Ever Been Disqualified for Violations of the Federal Motor Carrier Safety Regulations?
If You Answered "Yes" to Any of the Above Questions, Please Explain:

The United States Department of Transportation Requires that Driver Applicants State Their Date of Birth (§ 391.21(b)(2))

Date of Birth:



Driving Experience
Class of Equipment Type of Equipment From Date To Date Approximate Total Miles
Straight Truck
Tractor & Semi-Trailer
Twin Trailers - LVC's
Other:




List the States in Which You've Operated During the Last Five Years:
List Special Courses or Training You've Completed That Will Help You as a Driver:
List Any Awards Which You've Held and Who Presented Those Awards:

Accident Review for the Past Five Years
(Use the "Additional Information" Section if More Space is Needed)
Dates Nature of The Accident
(Head-on, Overturn, etc.) 		Fatalities Injuries
Additional Information:

Traffic Convictions and Forfeiture for the Past Three Years Excluding Parking Violations
Location Date Charge Penalty

FOR DEPARTMENT OF TRANSPORTATION REGULATED APPLICANTS

The following rights apply to the information provided by previous employers for the three years preceding the date of application:

  • The applicant has the right to review the information provided by previous employers;

  • The right to have errors in the information corrected by the previous employer and for that previous employer to re-send the corrected information to the prospective employer;

  • The right to have a rebuttal statement attached to the alleged erroneous information, if the previous employer and the driver cannot agree on the accuracy of the information.

Applicants wishing to review previous employer-provided investigative information must submit a written request to the prospective employer in accordance with 49CFR 391.23(i)(2).


APPLICANT STATEMENT

I certify that this application was completed by me and that all entries and information in it are TRUE and COMPLETE to the best of my knowledge. In the event of employment, I understand that false, misleading or omitted information may result in discharge.

I authorize investigation of all statements contained in this application as may be necessary in arriving at an employment decision. I understand that an investigation may be made and information may be obtained through interviews with past employers or personal references and/or driver's record check. This inquiry may include information as to, among other things, my character, general reputation and personal characteristics, as well as information about my work performance and workplace conduct. I consent to this investigation and to the consideration of any statements of references, former employers or others that are given in response to the inquiry.

I hereby release all parties, including but not limited to Vitran Express, personal references and previous employers, from liability for an injury or damage that may result from their furnishing information concerning me or any action Vitran Express takes on the basis of such information.

I understand that, if I am offered a job, it may be conditioned on the result of a physical examination and drug screen. I agree to furnish any medical information with reference to me as may be necessary in conjunction with that examination and related considerations. I understand that, according to federal law, all individuals who are hired must, as a condition of employment, produce certain documentation to verify identity and U.S. citizen status or, if aliens, legal authorization to work in the U.S. As a consequence, I understand that any offer of employment is contingent upon my ability to produce the required documentation within the time period required by law.

I understand that this application is not, and is not intended to be, a contract of employment and that any resulting employment is for no fixed period of time and is able to be terminated at any time and for any reason by me or Vitran Express. I further understand that statements which may be contained in policies, practices, or other material do not create any guarantee of employment and that Vitran Express has the right to modify, amend or terminate policies, practices, benefit plans or other programs within the limits and requirements imposed by law. I understand that no representative of Vitran Express, other than an officer, has the authority to enter into any agreement for any specific period of time or to make any agreement contrary to the foregoing and that any such agreement must be in writing to be binding.


I Have Read and Agree to the Applicant Statement