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DRIVERS APPLICATION FOR

EMPLOYMMENT

F1 FREIGHT SYSTEMS INC

7385 EAST DANBRO CRESCENT

MISSISSAUGA, ONTARIO

L5N 6P8

Applicant Name______Date of Application: ______

(Please print)

NOTE: In compliance with the Employment Equity Act, qualified applicants are considered for all positions without regard to colour, race, sex, religion, age, national origin, marital status, veteran status, non-job related disability or any other protected group status.

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Position (s) Applied for ______S.I.N ______

Name: ______DOB: _____/ _____/ _____

(Last)(First) (Middle)

Provide addresses of residency for the past 3 years.

Current address: ______

StreetCity

______Phone______How long: ______

ProvincePostal Code

Addresses: ______

StreetCity Province & Postal Code

How long? ______

______

StreetCity Province & Postal Code

How long? ______

Cell Phone number: ______Email address: ______

Emergency Contact:

Name______

First Last Middle Relationship Phone number

Date of Birth: ______/______/______Can you provide proof of age? ______

Year Month DayYes No

Have you worked for F1 FREIGHT SYSTEMS INC before? ______If yes, when? ______

Start date: ______Last day worked: ______Rate of pay: ______Position: ______

Reason for leaving: ______

How did you hear about F1 FREIGHT SYSTMES INC?

Magazine Newspaper Our Equipment Web Site Referred by an Employee ______

Rate of pay expected: ______

Do you have the legal right to work in Canada and the United States: Yes ______No ______

Is there any reason you would be refused entry into the United States? Yes______No______

If yes, please explain: ______

Have you ever been convicted of a felony? Yes_____ No _____

If yes, please specify such and explain. Conviction of a crime is not an automatic bar to employment. All circumstances will be considered.

______

Is there any reason you might be unable to perform the functions of the job for which you have applied? Yes_____ No_____

______

Please use the back of this page if you require more room for either of the above 3 questions. Conviction of a crime is not an automatic bar to employment. All circumstances will be considered.

EMPLOYMENT HISTORY

Starting from today and working backward, please list all of your employers for the past ten (10) years. All time must be accounted for; gaps of unemployment must be accompanied with an explanation. It is imperative that allrequested information be provided.

Period of UnemploymentStart _____ / _____ / _____Finish _____ / _____ / _____

Reason: ______

Period of UnemploymentStart _____ / _____ / _____Finish _____ / _____ / _____

Reason: ______

Period of UnemploymentStart _____ / _____ / _____Finish _____ / _____ / _____

Reason: ______

EMPLOYMENT HISTORY(continued)

EMPLOYER / DATE
Name / From: / To:
Address / Position held:
City Province Postal Code / Salary / wage:
Contact Person / Phone #
Reason for leaving / Fax #
Were you subject to the FMCSRs* while employed? Yes: No:
Was your job designated as a safety-sensitive function in any DOT-Regulated mode subject to the drug and alcohol testing
requirements of 49 CFR part 40? Yes: No:
EMPLOYER / DATE
Name / From: / To:
Address / Position held:
City Province Postal Code / Salary / wage:
Contact Person / Phone #
Reason for leaving / Fax #
Were you subject to the FMCSRs* while employed? Yes: No:
Was your job designated as a safety-sensitive function in any DOT-Regulated mode subject to the drug and alcohol testing
requirements of 49 CFR part 40? Yes: No:

*The Federal Motor Carrier Safety Regulations (FMCSRs) apply to anyone operating a motor vehicle on a highway in interstate commerce to transport passengers or property when the vehicle: (1) weights or has a GVWR of 10,001 pounds or more, (2) is designed or used to transport more than 8 passengers (including the driver), OR (3) is of any size and is used to transport hazardous materials in a quantity requiring placarding.

ACCIDENT RECORD

Please indicate any accidents for the past five (5) years. You may use the back of this page if more room is required. If none, please write NONE.

DATESNATURE OF ACCIDENTFATALITIES INJURIES HAZARDOUS

(head-on, rear-end, upset etc.) MATERIAL SPILL

Last Accident ______

Next Previous ______

TRAFFIC CONVICTIONS

Please indicate and traffic convictions and forfeitures for the past five (5) years (other than parking violations). If none, please write NONE.

LOCATIONDATECHARGEPENALTY

______

EXPERIENCE AND QUALIFICATIONS

Drivers License Number: ______Expiry: ______Province: ______Class: ______

Social Insurance Number: ______

Have you ever been denied a license, permit or privilege to operate a motor vehicle: Yes ______No ______

Has any license, permit or privilege ever been suspended or revoked:Yes ______No ______

If the answer to either of the above questions is yes, please provide details: ______

______

DRIVING EXPERIENCE Check Yes or No

CLASS OF EQUIPMENT / Circle Type of Equipment / DATES / Approx #
Fr (m/y) / To (m/y) / of Miles
Straight Truck Yes __ No __ / Van, Tank, Flat, Dump, Refer
Tractor & Semi-Trailer Yes __ No __ / Van, Tank, Flat, Dump, Refer
Tractor - Two Trailers Yes __ No __ / Van, Tank, Flat, Dump, Refer
Tractor - Three Trailers Yes __ No __ / Van, Tank, Flat, Dump, Refer
Motorcoach - School Bus Yes __ No __ / 8+ passengers
Motorcoach - School Bus Yes __ No __ / 15+ passengers
Other :

Please list Provinces and States you have operated in for the last five years: ______

______

Which, if any, sage driving awards do you hold and from whom: ______

______

Note any special courses or training that will help you as a driver: ______

______

FURTHER INFORMATION

Show any trucking, transportation or other experience that my help in your work for this company

______

If you have other courses or training, that you feel are relevant, please provide them below (IE: first aid / other areas of study)

______

Please provide any other special equipment or technical materials you can work with (other than those already noted)

______

EDUCATION

Circle highest grade completed: 1 2 3 4 5 6 7 8 High School: 9 10 11 12

LastHigh School attended: ______Location: ______

College / University (yrs completed): 1 2 3 4

Name of school: ______Location: ______

Course (s) taken: ______

Qualification obtained: ______Date completed: ______

TO BE READ AND SIGNED BY THE APPLICANT

This certifies that I, the applicant, have completed this application and that the information I have provided is true and complete to the best of my knowledge and I understand that providing false, misleading or incomplete information is grounds for immediate termination. I understand and agree to abide by all company policies, laws and regulations for the jurisdictions that I operate in. Failure to do so is grounds for termination of employment and / or contract. I also understand that employment offered to me is at the will of the Carrier and does not constitute any guarantee of employment and / or contract.

Name (print only): ______

Signature: ______Date: ______

EMPLOYMENT VERIFICATION REQUEST

I authorize all corporations, companies, educational institutions, persons, law enforcement agencies, military services, credit agencies and former employers to release information which they may have about me, together with reasons for termination concerning my employment, to F1 Freight Systems Inc and their agents, and release them from any liability or responsibility for doing so. Further, I authorize the procurement of my Motor Vehicle Record from my and all appropriate agency and an investigative consumer report. I understand that such a report may contain information about my background, character, and personal reputation and that further information may be available upon written request within a reasonable period of time.

A photocopy of this release shall be as valid as the original. If hired (or contracted), this authorization shall remain on file and shall serve as ongoing authorization during my employment (or contract) period.

In conformity with sections 382.413, 382.405 and 40.25 of Title 49 of the code of Federal Regulations, as prescribed by the US DOT, I hereby authorize my past or present employer(s) or their drug consortium to furnish to F1 Freight Systems Inc the following information concerning drug and alcohol tests, including pre-employment tests the carriers conducted; (1) the dates on which I tested positive for drugs, and the dates(s) involved; (2) the dates on which I tested 0.02 or greater for alcohol and the test levels; (3) the dates on which I refused to be tested for drugs and/or alcohol; (4)the results of my negative drug and/or alcohol tests with results below 0.02 as well any other violations of 49 CFR part 40.

I fully acknowledge, understand and agree that the information I authorize released involves tests which were required by the Department of Transportation (DOT), and may also include information concerning tests which DOT did not require, but which my past or present employer(s) may have voluntarily conducted under their own authority, unless I instruct the carriers in writing not to release information concerning non-DOT tests.

Authorization for release of personal information

7385 East Danbro Crescent, Mississauga, Ontario, L5N 6P8 ~ Ph: (905) 812-1337 Fx: (905) 812-7277

Pre- Employment Urinalysis

Notification

The Federal Motor Carrier Safety Regulations, Section 391.103; pre-employment testing requirements, apply to driver-applicants of this company.

As a condition of my employment, I agree to the urine sample collection and controlled substance testing.

I understand a positive test for controlled substances based on the Urinalysis Test will medially disqualify me from the operation of a commercial motor vehicle for this company.

The Medical Review Officer will maintain the results of the Urinalysis Test. Negative and positive results will be reported to the company.

My written authorization is required for the Urinalysis Test results to be given to other parties.

I have read and understand the above conditions for the Pre-Employment Urinalysis Notification.

______

Applicants Name (please print)

______

Applicants Signature Date ( d / m / y )

______

Company Representative Signature Date (d / m / y )