Employment Form - Lake Erie Transit

Personal Info

Name*

First Last

Email*

Phone*

Address*

Street Address Address Line 2 City State ZIP Code

How long at this address?

Previous Address?

How long at previous address?

Position applying for?

Salary Requirements?

Date available for work?

Referred by?

Are you 18 years or older?*

Yes
No

If not, birthdate

mm/dd/yyyyy

Availability

Total hours available per week*

Hours and Days available to work*

Are you legally able to be employed in the U.S.*

Yes
No

How did you hear about the job?

Do you have a car and valid drivers license?

Yes
No

If yes, from which State?

School most recently attended:

School Name

School Phone

School Address

City

State

Last Grade Completed

Grade Point Average

Graduated

Yes
No

Currently enrolled?

Yes
No

Most Recent Jobs:

Company

Phone

Address

Street Address City State ZIP Code

Job Title

Supervisor

Dates worked

Salary

Reason for leaving

Company

Phone

Address

Street Address City State ZIP Code

Job Title

Supervisor

Dates Worked

Salary

Reason for leaving?

Terms
1.) I certify that I have read and fully completed this application and that the information contained on the application is correct to the best of my knowledge and understand that any omission or erroneous information is grounds for dismissal in accordance with company policy.

2.) I authorize references listed on this application to give you any and all information concerning my previous employment and pertinent information they may have, personal or otherwise, and release all parties from all liability for any damage that may result from furnishing same to you.

3.) I acknowledge that the company reserves the right to amend or modify the policies in it's Handbook and other policies of the company at any time, without prior notice. These policies do not create any promises or contractual obligations between the company and its employees. I acknowledge that my employment is at will. This means I am free to terminate my employment at any time, for any reason, with or without cause, and the company retains the same rights.

I Agree

* By checking this box I agree that all of the above information is accurate.

Date