Web site:
Recruiter:

First name:
Last name:
Address 1
Address 2
,
Phone:
Other Phone:
Email:
Best time to call: AM PM Any Time
When to call:
Comments:

Answered yes to currently owns a truck .
Field values: Van
Straight truck
Tractor
What trucks interest you. Straight truck, Tractor or Van.
 (willing to purchase a truck)

Current O/O
Will Buy
Driver Only

Answered yes to question 5. Driver only. Not willing to purchase a truck. Only interested in being a driver for a current Owner.

Yes or No

MVR Info
Date Of Birth (dd/mm/yy):
Do you currently have a CDL?


Qualifying Questions
Can you be on the road for 2-3 weeks at a time?
Have you driven expedite before?
Have you ever tested positive for or refused to take a DOT drug/alcohol test?
Are you able to pass a DOT physical and drug test?
Have you ever had a DUI or DWI?
When did the DUI or DWI occur?
What and when?
Do you have unrestricted access into and out of Canada?
How many moving violations have you had in the past 60 months?
Has your drivers license been suspended longer than 30 days or revoked in the last 3 years?
How many preventable accidents or incidents have you had in the past 60 months?
Have you ever been the driverin a motor vehicle accident that resulted in damages exceeding $25,000?
Do you have a record of a preventable accident resulting in a fatality?
Important: Applicant can not have a record of a preventable accident resulting in a fatality!




Lead 11/07/20093Internet LeadInternet
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