AVOP Application form

AVOP AUTHORIZATION FORM
EMPLOYER'S STATEMENT
COMPANY:
TELEPHONE NO.:
(
)
COMPANY ADDRESS:
POSTAL CODE:
TITLE OF REQUESTING OFFICER:
NAME OF REQUESTING OFFICER:
I the undersigned certify that the applicant named herein has a requirement for an AVOP with our company.
They are eligible for the AVOP program and will be trained in AVOP by a qualified operator.
SIGNATURE OF REQUESTING OFFICER: (sign above)
DATE (yyyy/mm/dd)
EMPLOYEE'S STATEMENT
NAME:
TELEPHONE NO.:
(
)
HOME ADDRESS:
POSTAL CODE:
DATE OF BIRTH: (yyyy/mm/dd)
OCCUPATION:
PROVINCIAL DRIVERS LICENSE NO.:
HAVE YOU PREVIOUSLY HELD AN AVOP?
YES / NO
(circle one)
I hereby certify that, to the best of my knowledge, all the information provided above is true.
SIGNATURE OF APPLICANT (sign above)
DATE (yyyy/mm/dd)
AVOP AUTHORIZATION FORM
EMPLOYER'S STATEMENT
COMPANY:
TELEPHONE NO.:
(
)
COMPANY ADDRESS:
POSTAL CODE:
TITLE OF REQUESTING OFFICER:
NAME OF REQUESTING OFFICER:
I the undersigned certify that the applicant named herein has a requirement for an AVOP with our company.
They are eligible for the AVOP program and will be trained in AVOP by a qualified operator.
SIGNATURE OF REQUESTING OFFICER: (sign above)
DATE (yyyy/mm/dd)
EMPLOYEE'S STATEMENT
NAME:
TELEPHONE NO.:
(
)
HOME ADDRESS:
POSTAL CODE:
DATE OF BIRTH: (yyyy/mm/dd)
OCCUPATION:
PROVINCIAL DRIVERS LICENSE NO.:
HAVE YOU PREVIOUSLY HELD AN AVOP?
I hereby certify that, to the best of my knowledge, all the information provided above is true.
SIGNATURE OF APPLICANT (sign above)
DATE (yyyy/mm/dd)
YES / NO
(circle one)