Please print this page and mail or bring in to:          Matt Kilburn,   RS Express,  164 Kneeland St.  Boston   MA  02111

RS Express, Incorporated              Bike Messenger Employee Application

Today's Date:_______/______/_______

Name:_________________________________________________

Address:_______________________________________________________________

City/State/Zip Code:______________________________________________________

Telephone Number:_______________________ Pager Number:____________________

City of Boston Bicycle Messenger License #:________ Date of Issue:_____/_____/____

Proposed Start Date:______/______/______

Employee Number  (RSX Internal Use Only):__________________

Hours/Days Service is Available:_______________________________________________________________

Type of Entity: (Circle one)            Corporation        Partnership      Self-Employed

If Self-Employed, are principal and all assistants U.S. Citizens?    YES______ NO______

Special Comments:  Briefly describe any experience you have had in the courier industry or any particular points you may wish to cover during our decision process:

References:  Please list 2 business references that we may contact to inquire about the quality of your services.  These references must be current.

1.  Company Name/Contact Person:___________________________________________

            Telephone #: (____)______-______

2.  Company Name/Contact Person:___________________________________________

            Telephone #: (____)______-______

Note to All Applicants:  You must have a clean record of performance and conduct.   All references and records with the City of Boston will be checked.  You must provide a copy of your current license in the event your services are hired.

                    RSX Manager reviewing this information:________________ Date:______/______/______

Questions?   Call 617.350.0247 between 7am and 8pm Monday- Friday.

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