J.P. Anderson & Associates Inc.

Owner/Operator/Driver Form

Please fill out the form below. Please fill out all fields so that we can best assist you.

Contact Information:

  First Name
  Last Name
  Middle Initial
  Street number
  Street Name
  Apartment or Suite
  City or Town
  Postal or Zip Code
  Province or State

  Email Address
  Home Phone
  Cell Phone
  Preferred Method of Contact

  position applying for

Vehicle Information and Preferences

I want to work for   company
  License Class
  Year of Vehicle
  have my own trailer
  allow paint
  drive cross border

I want the company to pay for:

Select multiple fields by holding down the Ctrl Key and using the scroll arrow.

$.   I want to be paid per mile

  % is how I would rather be paid

Driving Record

  accidents     number of accidents
  traffic convictions   Convictions
  drunk driving charges
  years of Truck Driving experience

Please put any references below.
They can be from a past employer and don't have to be from your current one.

No Yes
You can post my information to the internet so that
companies can see that I am available as long as you remove
my Name, Street Address, Phone numbers, email and References.

Someone will contact you soon after you have submitted the form to J.P. Anderson & Associates Inc. or you can contact us to make sure your information has been received.

Contact Information
Jeff Anderson
J.P. Anderson & Associates Inc.
241 Amberly Blvd.
Ancaster, ON
Canada
L9G 3Y4

Office: 905-648-4583
Cell: 905-923-4583
Email: careers@jpanderson.com

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