CarGo West - Shipping in Grande Prairie, Alberta

Section A - About You

* First Name
*Last Name
*City you want to be based out of
*Current City
*Current Address
*Postal Code
Phone (Work)
Phone (Cell)
*Phone (Home)
*Email

Section B - Factual

*1. Do you have any demerits on your drivers abstract?
Yes No

*2. Have you been commercially insured by a company or independently for 3 years or more?
Yes No

3. Do you have any current safety tickets? (check all those that apply)

WHMIS
Dangerous Goods
TDG
H2S
First Aid

*4. Have you taken any self-improvement courses in the last year?
Yes No
If so which ones?

List courses

*5. Are you bondable?
Yes No

Section C - History

*1. What are you doing now for work?

*2. How long have you worked for your current or most previous employer?

*3. Where did you work before there?

Section D - Relative

*1. Do you consider yourself to be a safe driver?	Yes No

*2. How many sick days have you had in the last year?

*3. What do you consider to be a long day at work?

*4. How many hours in a day do you feel is ideal?

*5. How many hours in a week do you feel is ideal?

*6. How do you respond under pressure?

*7. Where do you see yourself in 5 years from now?

*8. Do you consider yourself physically fit and able to lift 100 pounds?
Yes No

*9. On a scale of 1-10, ten being the highest, how do you score yourself on:

A. Safety

Lowest	1	2	3	4	5	6	7	8	9	10	Highest
Lowest											Highest

B. Customer Service

Lowest	1	2	3	4	5	6	7	8	9	10	Highest
Lowest											Highest

C. Speed / Efficiency

Lowest	1	2	3	4	5	6	7	8	9	10	Highest
Lowest											Highest

*10. If presented with a task that seems impossible, you are likely to:

A. Tell the customer "We can't do this"

B. See if you can think of a way that "you" or "we" can still provide what they are looking for

C. Radio in to see if there are potential alternatives

D. Other

*11. Are you familiar with the area you are interested in?
Yes No

*12. Do you see any potential limitations that you may have in performing your duties?
Yes No

*13. What do you believe you can bring to CarGo West that will maintain or improve its quality of service to its customers?

*14. Provide 3 names or references.

I	Name:	Company: Position:	Daytime Phone: After Hours Phone:

II	Name:	Company: Position:	Daytime Phone: After Hours Phone:

III	Name:	Company: Position:	Daytime Phone: After Hours Phone:

*15. Are you most interested in a position as an owner/operator or as an employee?
Owner/Operator Employee

16. If owner operator, what kind of vehicle would you put on?

A. Year

B. Make

C. Model

*17. Do you currently have a trailer?
Yes No

If so, what kind?

A. Closed Top
B. Flat Deck

*Please list off the position that you are most interested in - see Current Openings

Position: