Drivers Questionnaire

The First Move to Become an Independent Contractor with Life Couriers

Looks like youʼre interested in becoming an Independent Contractor with Life Couriers (formerly On Time). All of our drivers are independent contractors and require a few things to get started. Please fill out the following questionnaire for further consideration.

Quick Note

You will need the following information about your vehicle to complete the questionnaire:

Make/Model
Year
Mileage

Vehicle Information

Does your vehicle meet the requirements?

If you plan to drive for Life Couriers (formerly On Time), a late model vehicle is required with 100,000 miles or less. Does your vehicle meet the requirement?
Fill out the following to find out:

Required Fields *

Driver History

Tell us a little about your life behind the wheel

A clean driving record with the DMV is required for further consideration.

Driver Information

Required Fields *

What is your Birthday? (mm/dd/yyyy)*

General Information

Contact Information

Required Fields *

Present Address

Required Fields *

Permanent Address

Required Fields *

Same as Present Address

Career Desired

Required Fields *

What date can you start? (mm/dd/yyyy)*

Are you currently employed?
YesNo

Have you applied here before?
YesNo

Education History

High School

Required Fields *

Did you Graduate?
YesNo

College

Did you Graduate?
YesNo

Other

Did you Graduate?
YesNo

Subjects of Special Study/Research

Have you served in the armed forces?

Employment History

Employer One

When did you start? (mm/dd/yyyy)

When did you leave? (mm/dd/yyyy)

Can we contact your current employer?
YesNo

Employer Two

Required Fields *

When did you start? (mm/dd/yyyy)

When did you leave? (mm/dd/yyyy)

Employer Three

Required Fields *

When did you start? (mm/dd/yyyy)

When did you leave? (mm/dd/yyyy)

Employer Four

When did you start? (mm/dd/yyyy)

When did you leave? (mm/dd/yyyy)

Professional References

Reference One

Reference Two

Reference Three

Resume

Upload Resume

Do you have a resume you would like to send us? If so, upload that here.

Authorization

Required Fields *

I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that falsified statements on this application shall be grounds for dismissal. I authorize investigation of all statements contained herein and the references and employers listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release the company from all liability for any damage that may result from utilization of such information. I also understand and agree that no representative or the company has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing, unless it is in writing and signed by an authorized company representative.

The following constitutes an electronic signature and is considered to be an acceptable form of signature representing your legal agreement to these statements.