Instructions: 1. All fields marked with a * are required  2. Incomplete information could affect the evaluation of your application 3. Please attach your resume by uploading it near the bottom of the form.
Position applied for:

Type of employment desired:
Personal Data
*Last Name *First Name Initial
Preferred Name or Nickname
*Address (Street #, name)
Apt. #
*City/Town *Province *Postal Code
Telephone Number(s) Area Code Number
*Do you have a valid driver's licence in good standing?
*Diversified Transportation Ltd. requires less than 3 demerits. Do you meet this requirement?
An NSC Driver's Abstract, Insurance Claims History and a photocopy of your Driver's License will be requested if an interview is scheduled.
Additional Information
NOTE: Because some of the factors are job requirements (e.g. valid driver's licence, professional license, and entitlement to employment), disqualification of some or change in status may result in re-assignment or termination of employment.
*1. *A) Have you been interviewed by Diversified Transportation Ltd. or any other Pacific Western Group company before?  
    *B) Have you worked for or have you completed pre-requisite testing for Diversified Transportation Ltd. or any other Pacific Western Group company before?
*2. Are you willing to relocate?
  *3. How did you hear about the employment openings with Diversified Transportation?
*4. Do you have a conviction for a criminal offence for which a pardon(or record suspension) has not been granted?
Note ** A Criminal conviction does not necessarily disqualify you from the position.
5. Have you been banned from any of the following plant sites?
Please attach a resume (Should be word or other email safe document):
Information requested in this application is treated confidentially.

I hereby declare that the foregoing information is true and complete to my knowledge. I understand that only applicants moving forward to the interview stage will be contacted and that a false statement may disqualify me from employment or cause my dismissal.

Please enter your full name    Date:  

The information collected on this form is deemed to be Personal Employee Information and is used solely to establish or determine suitability of a candidate for an employment relationship pursuant to Section 18(1) of the Personal Information Protection Act.