Application Form

Please fill in this form accurately, truthfully and in full. The information on this form remains confidential and is used for insurance, auditing and onboarding purposes only.

National Insurance Number

Driving License Number

Date of Birth (DD/MM/YY)

First name

Last Name

Mobile Telephone Number

Email address

Home Address (including postcode)

I am happy to be self employed as an independent contractor

Yes No

Have you driven a commercial vehicle in the last 12 months?

Yes No

Have you ever delivered parcels on behalf of Amazon?

Yes No

** Please give details of relevant commercial VAN driving experience (we will not proceed with your application without the relevant experience being demonstrated) **

If you have delivered packages for Amazon previously, please give details below

How many points do you have on your driving license?

0 3 6+

Do you have any of the following active endorsements IN, DR, CD, MS, UT or TT on your license?

Yes No

Have you ever been banned from driving?

Yes No

Is there anything in your past that you would expect to show on a Criminal Background Check (DBS)

Yes No

Please let us know anything that will come up on a DBS check

Please add any additional comments to support your application

By completing and submitting this form, I confirm that the information in this application is true and accurate and I am happy for my driving history to be passed on to PAINT Ltd's insurance company in case of an accident, claim or legal proceedings.

Type Name To Confirm Information Is Accurate and Truthful

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