Taxi Champlain - NEW MEMBERS

NEW MEMBERS

NEW MEMBERS APPLICATION FORM

For a taxi permit owner who is interested to become a member in our company must complete the following form.

A director will review your application and you will be contacted upon acceptance.

Name:

Address:

City:

Postal Code:

Telephone:

Cellular:

Driver's License No:

Pocket No.:

Vignette:

CTQ:

Restricted Permit:

Yes
No

How long have you been living at the same address ?

(Years)

How long have you been driving a taxi ?

(Total years)

In a company

Independant

Taxi company previously associated with :

What is the reason you choose to join Champlain Taxi LTD. ?

Previously associated with Champlain ?

Yes
No

I agree to follow and respect the rules and regulation of Champlain Taxi Ltd.

Date