Courier Driver Application Form

COURIER DRIVER APPLICATION
Driver Information
Full Name *

Prefix First Name Middle Name Last Name
Preferred Name/Nickname *
If this doesn't apply, just write NONE
Email *
example@example.com
Address *

Street Address

Street Address Line 2

City County

Postcode
Mobile Number *
Please enter a valid phone number.
Home Phone Number *

Area Code Phone Number
Date of Birth *

Day Month Year
Date
Are you eligible to work in the UK? *

Yes No
Do you have any motoring convictions in the last 3 years? *
If Yes to the above, please state motoring offences *
If this does NOT apply to you, just type NONE
How many points do you currently have on your licence? *
Do you have any other convictions? *
Please list any other convictions *
If this does NOT apply to you, just type NONE
Vehicle Details
Type of Vehicle *
Vehicle Make & Model *
Year of Vehicle *
Vehicle Registration *
Experience
Do you have any Courier or long distance driving experience? *
If this does NOT apply to you, just type NONE
How many years experience do you have? *
Load Area Dimensions & Cargo Weight
Maximum Cargo Weight kg:
Gross Payload kg
Load Area Height(cm):
Load Area Width(cm):
Load Area Length(cm):
Load Area Width Between Wheel Arches (cm):
Load Area Rear Door Entry Height(cm):
Load Area Rear Door Entry Width(cm):
Load Area Side Door Entry Height(cm):
Load Area Side Door Entry Width(cm):
How many Pallet Spaces?
Document Details
DVLA Driver's License Number *
DVLA Drivers Licence Expiry Date *

Day Month Year
Courier Insurance Provider *
Courier Insurance Policy Number *
Courier Insurance Expiry Date *

Day Month Year
Goods In Transit Insurance Provider *
Goods In Transit Policy Number *
Goods In Transit Insurance Expiry Date *

Day Month Year
Public Liability Insurance Provider *
If this doesn't apply, please type NONE
Public Liability Insurance Policy Number *
If this doesn't apply, please type NONE
Public Liability Insurance Expiry Date

Day Month Year
Attach a copy of the Following Documents: *

DVLA Driving Licence DVLA Driver Access Code MOT Certificate (if over 3 years) Courier Insurance Certificate Image of Vehicle Showing Registration Image(s) of Vehicle Load Area GIT Insurance Certificate Public Liability Certificate (if applicable)
Document Upload *

Cancel of
Availability
When are you available for work? *
Mondays

Hour Minutes

Until
until
Hour Minutes
Tuesdays

Hour Minutes

Until
until
Hour Minutes
Wednesdays

Hour Minutes

Until
until
Hour Minutes
Thursdays

Hour Minutes

Until
until
Hour Minutes
Fridays

Hour Minutes

Until
until
Hour Minutes
Saturdays

Hour Minutes

Until
until
Hour Minutes
Sundays

Hour Minutes

Until
until
Hour Minutes
Select which services appeal to you: *

Sameday Nextday Time Sensitive Local UK Nationwide Dedicated Deliveries
Rates
Your average mileage rate for your vehicle per mile? *
Your minimum Local Charge for your vehicle? *
Are you VAT Registered?
What is your VAT Number? *
If this does not apply to you, please type N/A
Thankyou for taking the time to fill out this form.

Please read the declaration below and if you are satisfied all the details are correct, please sign, date and submit below. We are looking forward to working with you and will be in touch shortly.
Declaration

By signing this application form, I accept the following:

1. The information I have provided is correct to the best of my knowledge.

2. My vehicle is fully insured.

3. I accept all the responsibilities for injury, damage and traffic violations.

4. I acknowledge that I do not smoke in the vehicle.
Signature *

Clear
Date *

Day Month Year
Date Document Signed
If you have any questions or anything you would like to add, please add it here:
CITY2CITY CARS & COURIERS
Email: support@city2citycars.co.uk
Should be Empty:

COURIER DRIVER APPLICATION

Driver Information

Vehicle Details

Experience

Load Area Dimensions & Cargo Weight

Document Details

Availability

Rates