Independent Contractor Courier Application YOU ARE APPLYING FOR AN INDEPENDENT CONTRACTOR COURIER POSITION ALL APPLICANTS MUST BE AT LEAST 21 YEARS OF AGE Name(Required) First Last Address(Required) Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Home Phone(Required)Cell PhoneIf different from home phone.Best time to call(Required) Hours : Minutes AM PM AM/PM Email Address(Required) Type of vehicle(Required) Bicycle Car Truck SUV Mini-van Cargo Van Box Truck Vehicle Year(Required)Please enter a number greater than or equal to 0.Vehicle Make & Model(Required)Do you have a valid Ohio driver's license?(Required) Yes No License Points(Required)How many years have you held a US driver's license (in any state)?(Required)Please enter a number greater than or equal to 0.How many tickets/accidents in the last three years regardless of points?(Required)Please enter a number greater than or equal to 0.Has your license been suspended within the last 3 years?(Required) Yes No What is the reason for your license suspension?(Required)List other convictions within the last 3 years:Would you be willing to submit to a criminal background check and drug screen?(Required) Yes No Insurance Company and level of coverage?(Required)BEST Courier requires Independent Contractors to carry full coverage with limits of 100/300/50.Last place of employment(Required)Are you still employed there?(Required) Yes No Last date employed?(Required) MM slash DD slash YYYY If no longer employed, why did you leave?(Required)List any other courier or delivery experienceDate available for work:(Required) MM slash DD slash YYYY What days of the week are you available to work? During what hours?(Required)What skills do you have that would make you a good courier?(Required)
