| Job title : |
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| First name : | |
| Last name : | |
| Email : | |
| Address : | |
| City : | |
| Country : |
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| Province/State : |
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| Zip code : | |
| Phone number : | () |
| Fax number : | () |
| Driver license number : | |
| Driver license class : | |
| Expiration date : | |
| Restrictions : | |
| Manuel transmission experience : | Yes No |
| Pneumatic brakes experience : | Yes No |
| B-train experience : | Yes No |
| Number of inaptitude points : | |
| Were you ever refused a driver's permit for a commercial vehicle? | Yes No If yes, explain : |
| Was your driver's permit ever revoked or suspended? | Yes No If yes, explain : |
| Ontario air-brake certification : | Yes No |
| Certificate of hazardous materials : | Yes No If yes, expiration : |
| Do you belong to a drug and alcohol testing program? | Yes No |
| Did you take a driving course for commercial vehicles ? | Yes No |
| You can speak : |
English
Français
Other
If other : |
| You can read : |
English
Français
Other
If other : |
| You can write : |
English
Français
Other
If other : |
| The qualifications you have for this position : | |
| Curiculum vitae : | |
Experience List of employers that you have worked for the past three years, beginning with the most recent. |
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| Employer (1) : | |
| Complete address : | |
| Phone number : | () |
| Functions : | |
| Weekly salary at your departure : | $ |
| Reason for departure : | |
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| Employer (2) : | |
| Complete address : | |
| Phone number : | () |
| Functions : | |
| Weekly salary at your departure : | $ |
| Reason for departure : | |
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| Employer (3) : | |
| Complete address : | |
| Phone number : | () |
| Functions : | |
| Weekly salary at your departure : | $ |
| Reason for departure : | |
| Communication : | English Français |
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