Careers

Applicant Information

Name*

First Last

Address*

Street Address Address Line 2 City Province Postal Code

Phone*

Email*

Social Insurance No.

Please enter a value between 0 and 999999999.

Date of Birth

Marital Status

Emergency Contact*

License No.*

Class*

Date Available*

Position Applied For*

Full Time or Part Time*

Full Time
Part Time

Do you have any physical or other conditions which may limit your ability to perform the duties of the position you are applying for?*

Yes
No

Desired Salary

If yes, explain*

Has your driver’s license ever been suspended or revoked?*

Yes
No

If yes, explain*

Have you ever been convicted of a criminal offence?*

Yes
No

Can you pass a drug test?*

Yes
No

Would you take a drug test?*

Yes
No

Education & Training

High School

Address

From

To

Did You Graduate?

Yes
No

Degree

College

Address

From

To

Did You Graduate?

Yes
No

Other

Address

From

To

Did You Graduate?

Yes
No

Degree

Have you received dangerous goods training?*

Yes
No

If yes, from where?*

Have you received first aid training?*

Yes
No

If yes, from where?*

Have you received H2S training?*

Yes
No

If yes, from where?*

Please list other courses taken

Previous Employment

Company

Phone

Address

Supervisor

Job Title

Starting Salary $

Ending Salary $

Responsibilities*

From

To

Reason for Leaving

May we contact your previous supervisor for a reference?

Yes
No

Previous Employment Two

Company

Phone

Address

Supervisor

Job Title

Starting Salary $

Ending Salary $

Responsibilities

From

To

Reason for Leaving

May we contact your previous supervisor for a reference?

Yes
No

Experience

How many years of experience do you have in

City Driving

Highway Driving

Off Road Driving

Loading Flat Decks

Loading Vans

Hauling Pipe

Loading Pipe

Pulling Decks

Pulling Vans

Chain Up

Super "B"

Other

Disclaimer & Agreement*

I Agree

I hereby give authority to Pipestone Carriers Inc. or their agents to investigate my background in order to ascertain any and all information of concern to my record, whether same is of record or not, and I release employers & persons named herein from all liability from any damage on account of their furnishing such information. I certify that all statements made in this application are correct to the best of my knowledge. Should any statement prove to be false, I understand that Pipestone Carriers Inc. can terminate my employment. I agree to have deducted from my pay, any training that I receive while employed by Pipestone Carriers Inc. should I quit or am dismissed from disobeying company policies set out in our manual if I do not stay for one year.

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Applicant Information

Education & Training

Previous Employment

Previous Employment Two

Experience

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