West Coast TRANSPORTATIONEMPLOYMENT APPLICATION
1015 HARGRIEVE ROAD LONDON ON N6E 1P6 PHONE: 519-685-2150 FAX: (519) 686-0854
ROBIN ENGLISH Email: Info@WestCoastTransportation.ca
You are welcome to return this application by attaching it to an email message. However, any information that has been
entered into this form may be subject to interception. In the interest of protecting your privacy, we recommend that you
please fill in the blanks, print your completed form and then mail or fax it to West Coast Transportation at the above
address or fax number.
To complete and return by email:
1. Press the TAB or ENTER key to move from box to box.
2. When done, from the File menu click Send To, select Mail Recipient (As Attachment).
3. Enter the email address: Info@WestCoastTransportation.ca and
4. Click Send to return.
First Name: Middle Name: Last Name:
City: Province/State: Postal/Zip Code:
Phone: 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 License Issuing Prov/State: Date of Expiry:
When did you obtain your Class 1A (AZ)?
How many years experience do you have pulling Reefers?
How many years experience do you have driving for Flatbeds?
How many years experience do you have driving for a Van?
(WE REQUIRE A MINIMUM OF 2 YEARS DRIVING EXPERIENCE)
Are you able to obtain an RCMP Clearance Certificate? YES NO
Do you have a FAST Card? 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
In the past 5 years, how many employers have you had?
Have you ever been denied a license, permit or privilege to YES NO
operate a vehicle?
Has any license, permit or privilege ever been suspended or YES NO
If the answer is yes to either of these questions, please provide
Thank-you for your interest in West Coast Transportation.