Quick Delivery Service, Inc.  Job Application Background Information Full Name Address City/State/Zip Phone E-mail How did you hear about Quick Delivery?

Position of Interest Driver   Customer Service   Sales   Other (if other, please specify)

As a driver, you will use your own vehicle, which is a : Car   Wagon or SUV   Pick-up   Minivan   Full-size Van   Truck

Full Time   Part Time   Date Available

If hired, can you furnish proof that you are eligible to work in the U.S.? Yes   No

Have you ever been convicted of a crime other than a traffic violation? Yes   No (if yes, please provide details)

For driver job only: Are you at least 23 years old? Yes   No

Do you have a valid driver's license? Yes   No Driver's license #:

Has your license been suspended or revoked in the last 3 years? Yes   No (if yes, please provide details)

What skills or training do you have that apply to the position you are interested in?

What interests you about this position?

Please provide information about your education and work experience. Include years completed in schools (high school, vocational school, college) and any diplomas or certificates earned.