Application For Lease Operators

Applicants must provide:

  • S.I.N. Card
    Photocopy of Current Drivers License
    Current Drivers License Abstract

    Drivers license and Abstract may be either mailed or faxed to us. For more information, please see our contact page.
First Name:
Last Name:
Address:
City:
Province: Postal Code:
Phone (with area code):
Social Insurance Number:
Drivers Lic. No: Province: Expiry:
Class: Restrictions:
Birthdate: (MM/DD/YYYY)
Party to be notified in case of emergency:
How long have you lived at your current address:
Renting or Buying
Previous Address:
City:
Province: Postal Code:
Do you have any physical defects:
Have you had a major illness in the last five years?
Have you received compensation for injuries?
If yes to any of the above, explain:
Are you physically capable of heavy manual work?

List and describe all accidents in the past 3 years:
Date: (MM/DD/YYYY) Description:
Charges? Injuries? Was it preventable?
Date: (MM/DD/YYYY) Description:
Charges? Injuries? Was it preventable?
Date: (MM/DD/YYYY) Description:
Charges? Injuries? Was it preventable?
Date: (MM/DD/YYYY) Description:
Charges? Injuries? Was it preventable?
Date: (MM/DD/YYYY) Description:
Charges? Injuries? Was it preventable?
Date: (MM/DD/YYYY) Description:
Charges? Injuries? Was it preventable?
Has your license ever been suspended or restricted?
Have you ever been convicted for driving under the influence of alchohol or drugs
Have you ever been refused a bond
Have you ever been refused entry into the United States?
If yes to any of the above, explain:

Describe education background:
High School (Name, City, Province)
How many years:      Dates:
College (Name, City, Province)
How many years:      Dates:
Trade School (Name, City, Province)
How many years:      Dates:
Driving School (Name, City, Province)
How many years:      Dates:
Other (Name, City, Province)
How many years:      Dates:
Other 2 (Name, City, Province)
How many years:      Dates:


Employment experience:
Company #1
Dates (from - to):
Contact Person (include Phone #):



Company #2
Dates (from - to):
Contact Person (include Phone #):



Company #3
Dates (from - to):
Contact Person (include Phone #):





May we contact your previous employers for references?
Personal Reference 1
Name:
Address:
Phone:


Personal Reference 2
Name:
Address:
Phone:

 

Declaration

Please read the following carefully.

As a condition of my employment, I agree to the following:

1. As a condition of my employment, I agree to the urine sample collection and controlled substance testing at a facility designated by Rheinland Transportation Ltd. If employment is terminated by either party within six months, the cost of such testing will be deducted from pay.

2. I declare the information given by me in this Application for Employment is an accurate statement of the facts.

3. I authorize investigation of all statements in this application and understand that any misrepresentation or omission of facts shall be cause for dismissal, without recourse.

4. In the event of my employment, I agree to abide by the work-related rules and regulations.

5. It is understood that, if hired, the applicant will be on probation for a period of ninety days during which the applicant can be fired without recourse.

6. Any chargeable claims and/or preventable accidents may result in a $250.00 (Canadian Funds) deduction per occurence.

I have read the above terms, and agree to them: