To book a test drive, please complete the following form. Once your form has been received, a representative will contact you to confirm your appointment. Please ensure that all items are completed properly.

PERSONAL

First Name Last Name Address City Postal Code Email Home Phone Alternate Phone Job applied for: Title Rate of pay expected:   per How did you learn of this opening: Do you want to work... Full-Time or Part-Time Have you worked for us before? Yes No If yes, when..? If hired, on what date will you be available to start work? January February March April May June July August September October November December 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 2004 2005 If hired, do you have reliable means of transportation to get to work? Yes No

EDUCATIONAL BACKGROUND

Level Year Completed Diploma/Degree Highschool 9101112 Undergraduate (college/university) 1234 Graduate/Professional 1234

Describe Course of Study Describe any specialized training, apprenticeship skills and extra-curricular activities Describe any honours you have received

RELEVANT WORK EXPERIENCE

List in order, starting with most recent

From January February March April May June July August September October November December 2004 2003 2002 2001 2000 1999 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 To January February March April May June July August September October November December Present 2003 2002 2001 2000 1999 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985

Name of Employer Address Phone #

Rate of Pay: Start Finish (or current)

Supervisor's name and title Reason for leaving (if applicable) Describe in detail the work you did/do.

From January February March April May June July August September October November December 2004 2003 2002 2001 2000 1999 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 To January February March April May June July August September October November December Present 2003 2002 2001 2000 1999 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985

Name of Employer Address Phone #

Rate of Pay: Start Finish (or current)

Supervisor's name and title Reason for leaving (if applicable) Describe in detail the work you did/do.

From January February March April May June July August September October November December 2004 2003 2002 2001 2000 1999 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 To January February March April May June July August September October November December Present 2003 2002 2001 2000 1999 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985

Name of Employer Address Phone #

Rate of Pay: Start Finish (or current)

Supervisor's name and title Reason for leaving (if applicable) Describe in detail the work you did/do.

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