Career with Akal

Please fill below form/application for New Hire

Driver Information

Name: Email:
License: Date of Birth(MM-DD-YYYY):
Driver License Class/Type: Original date of obtaining Driver License Class/Type:
Province Issuing this Driver's License: Total number of years if commercial driving:

DRIVING POSITION BEING OFFERED/EMPLOYED

Name/Address of the Trucking Company for whom you will be driving:

What types of vehicle will you be required to operate:

Tractor Trailer: Straight Truck with trailer: Straight Truck without trailer: Light Commerical Vehicle:

Please indicate which of the following, if any, will form part of your current/proposed employment

Bulk Liquids: Train Configurations: Float type trailers : Drop-type trailers:
Carrying logs or pulpwood : Operating in the woodlands: Operating in the oilfields : Haling sand, gravel, earth or stone:
Hauling steel products : Hauling oversized, or overwight loads : Livestock :

PREVIOUS DRIVING QUALIFICATIONS

What types of vehicles have you actually driven for commerical employment ?

Tractor Trailer: How many years ?
Straight Truck with trailer: How many years ?
Straight Truck without trailer: How many years ?
Light commerical Vehicle: How many years ?
Have you qualified for or obtainted the C.T.H.R.C. "Earning Your Wheels" certificate ?
Have you qualified for or obtainted a certificate P.T.D.I driver training course ?
Have you qualified for or obtainted any other professional truck driver trainig course ?

PREVIOUS DRIVING EMPLOYMENT INFORMATION (Upto 3 years history must be provided)

Past Employer 1
Name/Address of the Trucking Company for whom you will be driving:
Supervisor Name: Phone:
Employment Start Date: Employment End Date:

What type of vehicles did you operate most often for this employer ?:

Tractor Trailer: Straight Truck with trailer: Straight Truck without trailer: Light Commerical Vehicle:

Please indicate if your drivind position with this employer required you to operate in any of the following situations;

Bulk Liquids: Train Configurations: Float type trailers : Drop-type trailers:
Carrying logs or pulpwood : Operating in the woodlands: Operating in the oilfields : Haling sand, gravel, earth or stone:
Hauling steel products : Hauling oversized, or overwight loads : Livestock :

Past Employer 2
Name/Address of the Trucking Company for whom you will be driving:
Supervisor Name: Phone:
Employment Start Date: Employment End Date:

What type of vehicles did you operate most often for this employer ?:

Tractor Trailer: Straight Truck with trailer: Straight Truck without trailer: Light Commerical Vehicle:

Please indicate if your drivind position with this employer required you to operate in any of the following situations;

Bulk Liquids: Train Configurations: Float type trailers : Drop-type trailers:
Carrying logs or pulpwood : Operating in the woodlands: Operating in the oilfields : Haling sand, gravel, earth or stone:
Hauling steel products : Hauling oversized, or overwight loads : Livestock :

Past Employer 3
Name/Address of the Trucking Company for whom you will be driving:
Supervisor Name: Phone:
Employment Start Date: Employment End Date:

What type of vehicles did you operate most often for this employer ?:

Tractor Trailer: Straight Truck with trailer: Straight Truck without trailer: Light Commerical Vehicle:

Please indicate if your drivind position with this employer required you to operate in any of the following situations;

Bulk Liquids: Train Configurations: Float type trailers : Drop-type trailers:
Carrying logs or pulpwood : Operating in the woodlands: Operating in the oilfields : Haling sand, gravel, earth or stone:
Hauling steel products : Hauling oversized, or overwight loads : Livestock :

CLAIM HISTORY

Have you had any "any fault" accidents during the last 3 years ?

If Yes, Please complete table below, Otherwise the driver profile will not be accepted.

Date of Accident Describe event and location % "at fault"

Comments




   I certify that all the information is true and correct. I authorize SGI Canada Insurance to complete background investigation including obtaining a current Drivers Abstract in accordance with provincial and federal laws. I authorize my previous employer employers to release any information requested by SGI Canada Insurance and hold them harmless of all liability from the release of said information.
I certify that I am legally entitled to work s a truck driver according to all provincial, state and federal laws pertaining to age, medical condition, drug testing requirements, immigration or work entitlement status in each jurisdiction required by my current/proposed employment.

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