Job Application Position Applying For*Class 1 DriverHeavy Equipment TechnicianJourneyman WelderCrane OperatorSwamper/LaborerWinch Tractor OperatorBed Truck OperatorLoader OperatorDate of Application* Name* First Last Date of Birth* Home PhoneCell PhoneEmail* Current Address* Street Address City AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland & LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code Previous Address Street Address Address Line 2 City Postal Code Emergency Contact*Relationship*Highest grade or education degree completed*Physical limitations (if any)Job related injuries (if any)Any lost time from work due to illness or injury?*YesNoDriver's License #*Class*Province or State of issue*AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland & LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukonAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificOther (International)Other (International)*Date of expiry* Air ticket?*YesNoDemerits on license*Has license ever been suspended?*YesNoAs part of your hiring process AND during your employment with Allnite Trucking Ltd we require a current Commercial Driver’s abstract from you. Should we find your license has excessive demerit points or any license suspension or loss of license due to alcohol or illegal substance, we reserve the right to refuse or terminate your employment/contract without notice.Employment HistoryAll applicants must provide the following information on all employers during the preceding 3 years. List complete mailing address, street number, city, province, and postal codes.Employer Name (Present)* Address* Street Address City AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland & LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code Contact* First Last PhoneStart Date* End Date* Position Held*Salary/WageReason for LeavingMay we contact your present employer (if any) to verify your work record?YesNoPeriod of unemployment (if any)From To Past EmploymentEmployer Name Address Street Address City AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland & LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code Contact First Last PhoneStart Date End Date Position HeldSalary/WageReason for LeavingDo you have additional past employment? Yes Employer Name Address Street Address City AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland & LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code Contact First Last PhoneStart Date End Date Position HeldSalary/WageReason for LeavingDo you have additional past employment? Yes Employer Name Address Street Address City AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland & LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code Contact First Last PhoneStart Date End Date Position HeldSalary/WageReason for LeavingPlease check off the equipment you are proficient in operating* Bed Truck Pole Truck Winch Tractor Mobile Crane 8-20 ton Mobile Crane 20-30 ton Mobile Crane 30-45 ton Tractor Trailers - Tri axel Wheelers Jeeps Boosters Certificates you hold Standard 1st Aid H2S Alive PST CSTS Standard 1st Aid Expiry H2S Alive Expiry Other CertificatesAre you able to work flexible hours?*YesNoAre you able to work away from home for extended periods of time?*YesNoAre you able to complete a pre-employment medical and drug/alcohol screen at our company request?*YesNo