Industrial Breakdown Couriers

ISO 9001 Certified Firm

Commission/Broker Application Form                      
Name
Reply Email:
Date of Birth :
Address :
City :
Postal :
Home : #
Pager : #
Mobile : #
Driver License : #
Previous Employer :
Address of Employer :
Length of Employment :
Make of Vehicle :
     Plate#:
Year of Vehicle :
Name of Insurance Co. :

Name of Insurer :
      Policy :    
Name of Registration Co. :
GST Registration Number :
Qualifications/ Prerequisites

- I am over the age of 18.
- I am able to communicate in English, both verbal and written.
- I own a pick-up or cargo van of model year 2002 or newer.
- I am willing to travel all over Ontario and Quebec. 
- I am able to financially operate my vehicle for 15 days before drawing pay.
- I have delivery experience

By checking this box you have answered yes to the above qualifications

     

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