MGM Courrier - Subcontracting request

Name*

Email*

Address*

Postal code*

Phone 1*

Phone 2

Cell

Pager

Nature of activities

Date of Birth (JJ-MM-AAAA)*

Have you ever worked for a courier company before?*

Name of last employer, contractor or associated*

Phone

Type of Business

How long

Your duties

Salary or Fees

Date of termination (JJ-MM-AAAA)

Reason for termination of your services

Do you know anyone in our employment under a contract or subcontract with the present contractor?*

Reason for termination of your services

References 1

References Phone 1

References 2

References Phone 2

If you checked "car" or "truck", do you own the vehicle?

Name of your auto insurance company

Constructor and year of car or truck

Who should we contact in case of accident?*

Phone 1*

Phone 2*

Are you subject to caution (criminal record)?*