LogiCode

General Information

First Name *

Last Name *

Address *

Do you have a G License? *

Yes

No

Please list prior 3 year addresses here

Date of Birth *

Month

Day

Year

Phone Number *

E-mail *

Have you ever been convicted/charged for a crime that you were not pardoned for? *

Yes

No

Are you eligible to work in the Canada? *

Yes

No

Are you at least 21 years of age or older? *

Yes

No

License Information

Do you have a VALID G license for the past 24 months? *

Yes

No

License Class *

License Number *

State of Issue is Ontario or outside of Ontario? *

Driver's License *

Browse Files Drag and drop files here

SIN and/or Work Permit *

Browse Files Drag and drop files here

Driver's Abstract (Max 6 months old) *

Browse Files Drag and drop files here

Criminal Clearance

Browse Files Drag and drop files here

License expiration date *

Month

Day

Year

Previous Experience *

None

Amazon

Sober

Canada Cartage

Staffing Agency

Other

Please list any licenses held in other states for the previous 5 years, include license numbers if you can.

Were you ever in the military? *

Yes

No

Additional Information

Have you had any violations in the last 5 years? *

Yes

No

If yes, please give date, explanation, city, county and state and if you received ticket/fine (amount)

Emergency contact information

First Name *

Last Name *

Address

Relationship to you *

Phone Number *

Official Disclosure Statement

Official Disclosure Statement: 

I certify that this application was completed by me and that all entries and information are true and complete to the best of my knowledge. A false statement in my application or interview(s)may disqualify me from placement or result in subsequent termination for just and sufficient cause if I am placed by LogiCode. I also understand that I am required to abide by all rules and regulations of the company, as permitted by law. I authorize LogiCode to make such investigations and inquiries of my personal employment or medical history, financial (credit bureau), criminal record search, driving abstracts, drug results from previous employers or their consortium or their Insurance Carrier or Agent, or from third party for my driving record, insurance history, and other related matters as may be necessary in arriving at an employment decision with my application. I hereby release employers, school, or person from all liability in responding to inquiries in connection with my application. I authorize LogiCode to use the information supplied by me (including, without limitation, sensitive personal data) to aid the recruitment process and associated administrative functions. This involves LogiCode, amongstother things, processing and storing information (including, without limitation, sensitive personal data) and passing or making available such information to prospective employers and clients. LogiCode may also use third parties to help process my information as part of the recruitment process. I understand that LogiCode and/or their agents may keep any information on file including work performance as related to my employment period and make it available to any second party.
Authorization to Release Records

I authorize the carrier subscribers indicated on this application to do a complete background investigation in accordance with state and federal laws. I authorize my previous employers to release any information requested by these carrier subscribers and hold them harmless of all liability from the release of said information. 

I hereby request and authorize to cause to be conducted, at any time, an investigation of my background for employment purposes, which may include, but is not limited to, any information relating to my character, general reputation, personal characteristics, criminal history, past work experience, educational background, alcohol or drug test results, or failure to submit to an alcohol or drug test, or any other information about me which may reflect upon my potential for employment gathered from any individual, organization, entity, agency, or other source which may have knowledge concerning any such items of information. I have completed this application of my own free will and hold harmless of all liability all companies, agents and associated parties for the use of this application.

I acknowledge that it is my responsibility to keep my driver's license up-to-date, and with me always while on duty. I authorize LogiCode to request and obtain a driver’s record /abstract on my behalf and deduct any associated fees from my payments. I understand that, while qualified as an approved driver with LogiCode, a current copy of my abstract, at times, might be required. And, if deemed appropriate, more regular updates will be obtained. I authorize LogiCode to deduct any associated fees from my payments for obtaining medical records/testing, background search, abstracts, and any other fees/fines/penalties or tickets that I have incurred. I authorize LogiCode to deduct the costs from my payments that are accrued by my actions or from any
accidents/incidents caused by me, including damages to any equipment’s and properties. I acknowledge that any misconduct on duty with the client or customer(s) of the client, Dispatcher, or with the staff, on any occasion, is subject to dismissal. I understand that upon late arrival, client can send me home without pay. I can be further fined by the client for up to $50.00, which will be deducted from my pay. I understand that No-Show is a careless act and creates a negative image for LOGICODE. Upon a No- Show, client can fine me up to $100.00 per day. I understand that any traffic or parking tickets or 407 ETR bill/fine I receive while on duty, due to my negligence, shall be paid in full by me, or such amount will be deducted from my payments. I understand that I am required to provide my Banking information at the time of registration.
Any late Banking information can delay my pay to the next pay period. I understand that my first payment will be made after the first 2 weeks worked. After which, it will be Biweekly. LogiCode can choose, but not liable, to pay me weekly when possible. Unless otherwise instructed specifically by text, I am not to use the 407 ETR Highway on duty. I understand I must IMMEDIATELY report any incident/accident to the Safety and Compliance, Dispatch, and to LogiCode. I acknowledge that I have been presented with health, safety, and operating Procedures, and I have reviewed and understand them. I acknowledge that I must NOT utilize any equipment presented to me for my personal use. I understand that on duty, under NO circumstances, unless instructed by text, am I to accompany any related or non-related passengers.

By signing I agree I have read the above statements *

Signature *

LogiCode Inc.

SUBCONTRACTORS APPLICATION

Please fix the following errors:

General Information

License Information

Additional Information

Emergency contact information

Official Disclosure Statement