Toronto Drive-Away Service (Nationwide) Inc. (This is not an Application for Employment)
This Application requires a valid driver's license and proof thereof
Your email address: Present date: Date leaving:
Destination (City): Province: Depart From (City):
Last Name: First Name:
Permanent Address:
Home Phone: Business Phone:
Name and Address of Person accompanying driver.
1.
References information:
1. Occupation: Phone:
2. Occupation: Phone:
3. Occupation: Phone:
The following information is required for identification purposes only:
Age: Date of Birth: Weight: Height:
Hair Colour: Eye Colour: Glasses: Sex: Marital Status:
Spouse Name: Address: Phone:
Next-of-kin Name to contact in an emergency:
Relationship: Address: Phone:
Drivers License no.
Expires: Province:
Driving Experience in Years: Cash on hand after deposit:
Name of Employer: Address:
Reason for trip:
Destination Address: Phone:
The following information is required for proper border crossing documentation:
Nationality: Place of Birth:
Type of vehicle most familiar with:
Do you have a Criminal Record now? Yes No
Have you ever had a Criminal Record? Yes No
DRIVING RECORD
(1) Has your license ever been suspended? Yes No
If Yes, when? What for?
For How Long?
(2) Have you ever been charged with impaired driving? Yes No
If Yes, when?
(3) Have you ever been charged with careless driving? Yes No
(4) Have you had any speeding tickets during the last 3 years? Yes No
If Yes, how many?
(5) Are there any demerit points against your license at present? Yes No
If yes, how many? What did you lose them for?
(6) Are there any unpaid fines outstanding against you at present? Yes No
