ONEXBUS Driver Application Form Join ONEXBUS TEAM! Driver Application Form ONEXBUS Driver's Application for EmploymentΔAPPLICANT INFORMATIONSave & Resume LaterFirst NameMiddle NameLast NamePhone/MobileEmailDate of BirthPosition Applied for- Select -Coach/School Bus DriverOn-Demand Transit OperatorDate of ApplicationDate Available for WorkDo you have legal right to work in Canada? Yes NoCan you legally cross the U.S. Border? (A criminal search record, I-94 Card, or Passport is required) Yes NoAre you presently employed? Yes NoIf no, how long since leaving last employment:List any restrictions you would have working an irregular schedule:RESIDENCY HISTORY Previous five years residency, beginning with your current mailing address: NUMBER - STREET CITY PROVINCE POSTAL CODE # OF YEARS AT ADDRESS LICENSE INFORMATIONCheckbox Field No person who operates a commercial motor vehicle shall at any time have more than one driver’s license (49 CFR 383.21). I certify that I do not have more than one motor vehicle license, the information for which is listed below. Include all licenses held for the past 3 years, starting from your current license: PROVINCE LICENSE # TYPE/CLASS ENDORSEMENTS EXPIRATION DATE PHYSICAL HISTORYWould you be willing to submit to a pre-employment medical examination? Yes NoWould you be willing to submit to a pre-employment urinalysis (substance abuse) test? Yes NoDo you have any physical limitations, which may limit your ability to perform the job applied for? Yes NoIf YES, please explain:Are you physically capable of performing heavy manual labor? Yes NoIf NO, please explain:How much lost time due to injury have you suffered in the past three years?TRAFFIC CONVICTIONS AND FORFEITURESCheckbox Field Check this box if none. Traffic convictions and forfeitures for the past 5 years, starting from the most recent (other than parking violations): DATE CONVICTED (Month/Year) VIOLATION PROVINCE OF VIOLATION PENALTY (Forfeited bond, collateral and/or points) Have you ever been denied a license, permit, or privilege to operate a motor vehicle? Yes NoIf YES, please explain:Has any license, permit, or privilege ever been suspended or revoked? Yes NoIf YES, please explain:What safe driving awards do you hold?How many accident-free driving years do you currently have?ACCIDENT RECORDCheckbox Field Check this box if no accident records. Accident records for the past 5 years, starting from the most recent: DATE NATURE OF ACCIDENT (Head-on, rear-end, upset, etc.) # FATALITIES # INJURIES CHEMICAL SPILLS YesNo EMPLOYMENT HISTORYThe Federal Motor Carrier Safety Regulations (49 CFR 391.21) require that all applicants wishing to drive a commercial vehicle list all employment for the last three (3) years. In addition, if you have driven a commercial vehicle previously, you must provide employment history for an additional seven (7) years (for a total of ten (10) years). Any gaps in employment in excess of one (1) month must be explained. Start with the last or current position, including any military experience, and work backwards. You are required to list the complete mailing address, including street number, city, state, postal code; and complete all other information. Employer Name Phone Address Role From (mm/yy) To (mm/yy) Reason for Leaving Confirmation 1* (see below) Confirmation 2* (see below) SELECTYESNO SELECTYESNO (*) Confirmation questions Confirmation 1: While employed here, were you subject to the Federal Motor Carrier Safety Regulations? Confirmation 2: Was the job designated as a safety-sensitive function in any Department of Transportation-regulated mode subject to alcohol and controlled substances testing as required by 49 CFR, part 40?Explain any gaps in employment (Include month/year)Are there any employers in the referral list we should not contact for reference? Yes No If yes, list their names hereunder and explain the reason. If left empty, you are extending the authority to us to contact any or all the referred employer(s) for verification! EMPLOYER NAME REASON FOR EXCLUSION DRIVING EXPERIENCEFor each employer listed in this application form; please list the type of equipment operated. e.g. Coach Bus, School Bus, etc. CLASS OF EQUIPMENT: HIGHWAY CRUISER/COACH TYPE OF EQUIPMENT (VAN, TANK, FLAT, ETC.) DATE FROM DATE TO APPROX # OF MILES (TOTAL) CLASS OF EQUIPMENT: SCHOOL BUS TYPE OF EQUIPMENT (VAN, TANK, FLAT, ETC.) DATE FROM DATE TO APPROX # OF MILES (TOTAL) CLASS OF EQUIPMENT: OTHER TYPE OF BUSES TYPE OF EQUIPMENT (VAN, TANK, FLAT, ETC.) DATE FROM DATE TO APPROX # OF MILES (TOTAL) CLASS OF EQUIPMENT: STRAIGHT TRUCK TYPE OF EQUIPMENT (VAN, TANK, FLAT, ETC.) DATE FROM DATE TO APPROX # OF MILES (TOTAL) CLASS OF EQUIPMENT: TRACTOR & SEMI-TRAILER TYPE OF EQUIPMENT (VAN, TANK, FLAT, ETC.) DATE FROM DATE TO APPROX # OF MILES (TOTAL) CLASS OF EQUIPMENT: OTHER TYPE OF EQUIPMENT (VAN, TANK, FLAT, ETC.) DATE FROM DATE TO APPROX # OF MILES (TOTAL) Please select Provinces or Territories you have operated a commercial vehicle in during the past 5 years. Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan YukonDo you have experience in operating a commercial vehicle in the US during the past 5 years? Yes NoPlease select States you have operated a commercial vehicle in during the past 5 years. Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Armed Forces Americas Armed Forces Europe Armed Forces PacificAre there any provinces or states that you will not or cannot operate in? Yes NoIf YES, please list:Are you able to complete a logbook properly? Yes NoIf NO, please explain:EDUCATION Please list your education starting from the most recent: SCHOOL NAME & LOCATION COURSE OF STUDY YEARS COMPLETED GRADUATED? DETAILS High SchoolCollegeOther YesNo OTHER QUALIFICATIONSPlease list any other qualifications that you have and which you believe should be considered.EMERGENCY RESPONSEYour Name: Date / TimeWhom should we contact in case of emergency?Phone NumberRelationshipDo you have any medical conditions we should be aware of?If unable to contact the above person, may we contact your personal doctor? Yes NoDoctor's Name: Phone NumberAPPLICANT CONSENT As , I authorize you to make investigations (including contacting current and prior employers) into my personal, employment, financial, medical history, and other related matters as may be necessary in arriving at an employment decision. I hereby release employers, schools, health care providers, and other persons from all liability in responding to inquiries and releasing information in connection with my application.In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I also understand that I am required to abide by all rules and regulations of the Company.I understand that the information I provide regarding my current and/or prior employers may be used, and those employer(s) will be contacted for the purpose of investigating my safety performance history as required by 49 CFR 391.23. I understand that I have the right to: Review information provided by current/previous employers. Have errors in the information corrected by previous employers, and for those previous employers to resend the corrected information to the prospective employer; and Have a rebuttal statement attached to the alleged erroneous information, if the previous employer(s) and I cannot agree on the accuracy of the information. This certifies that I completed this application, and that all entries on it and information in it are true and complete to the best of my knowledge. Note: A motor carrier may require an applicant to provide more information than that required by the Federal Motor Carrier Safety Regulations.Save ProgressDOCUMENT UPLOADSPlease upload the following documents below: Current Drivers License Copy Current Drivers License Abstract (under 30 days) Current CVOR Record Search (under 30 days) Criminal Record Search Tip: If you need time to gather documents, click Save Progress button above and return later.File UploadDrag & Drop or Choose File(s) Submit
