Application For Employment Form Step 1 of 5 20% The information supplied in your application will be treated in the strictest of confidence. STAR Transit is an Equal Opportunity Employer and shall provide equal employment opportunity to its staff, potential employees, and applicants for employment on the basis of fitness and merit without regard to race, color, religion, national origin, political affiliation, sex (including gender identity and sexual orientation), age, genetic information, disability, veteran status, or other protected class. Position Applied For:*Available Start Date* Date Format: MM slash DD slash YYYY Personal InformationName* Mr.Mrs.MissMs.Dr.Prof.Rev. Prefix First Last Address Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Daytime Phone*Alternate PhoneEmail* Type of Employment: Full-Time Part-Time Temporary Have you been employed by STAR before?*YesNoPlease enter the most recent time dates you were employed by STAR TransitStart Date Date Format: MM slash DD slash YYYY End Date Date Format: MM slash DD slash YYYY Do you understand the job requirements?*YesNoWould you be available to work overtime, if necessary?YesNoIf offered employment, can you furnish proof of legal right to work within the United States?*YesNoList any name(s) you were previously employed under: Education and QualificationsDid you graduate from high school or receive a GED certificate?YesNoBusiness/Technical/Vocational ProgramDo you have a certificate or degree from a technical or vocational college?YesNoTechnical/Vocational School NameLocationHours EarnedDegree/Certificate EarnedProgram/Field of StudyCollege/University (Undergraduate)Did you attend/are you currently attending a college or university?YesNoCollege/University NameLocationDegree EarnedMajorDo you possess a valid driver's license?YesNoLicense Expiration Date MM DD YYYY License ClassLicense Restrictions(If any)Do you have a passenger endorsement? Yes No N/A Expiration date of passenger endorsement Date Format: MM slash DD slash YYYY Do you have a current DOT physical? Yes No N/A Expiration date of DOT physical Date Format: MM slash DD slash YYYY Can you speak or write any languages other than English?YesNoLanguage ProficienciesPlease list all languages as well as your proficiency (verbal, written, both, fluent) in each. Additional Licenses and CertificatesPlease list all other current licenses and certificates relevant to the position you are applying for, e.g. CPR/First Aid or Defensive Driving Skills and ProficienciesPlease list any other relevant skills you posses, including computer software and equipment you can operate Other InformationCriminal History*Have you in the last 10 years, under your name or another name, been convicted of, pleaded guilty or nolo contendere to, received deferred adjudication for, or been on any form of diversion for any criminal offense? If yes, please provide brief details.YesNoExplanation of Criminal HistoryIf yes, please provide brief details of criminal history in the past 10 years:Criminal History continued*Have you ever, under your name or another name, been convicted of a crime, which resulted with your being in prison and released from prison or paroled? If yes, please provide brief details.YesNoCriminal History ExplanationIf yes, please provide brief details:Moving violations*Have you had any moving violations and/or accidents in the past three (3) years? YesNoList of moving violations and/or accidentsIf yes, please provide a list:Drug Test Screening*Have you failed an employer's drug or alcohol test in the last three (3) years?YesNoExplanation of Drug Test ScreeningPlease explain the incident(s) in which you failed a drug or alcohol test.DUI*Have you ever been convicted for driving under the influence (DUI)? YesNoDisciplinary HistoryHave you ever been terminated or asked to resign from a job?YesNoExplanation of Disciplinary HistoryList all cases where you were terminated or asked to resign from a jobAre you related to anyone who is currently employed by STAR Transit?*YesNoRelated Person's Name First Last DepartmentRelationship Military ServiceMilitary serviceWere you ever in the armed forces?YesNoMilitary service detailsIf yes, please provide the branch and your dates of service:Skills/abilitiesPlease describe any special skills or abilities you obtained as a result of service in the military:Employment HistoryList each job separately. Do not use references such as "See Resume" in place of completing this section.Current employment statusAre you currently employed?YesNoHow many jobs would you like to enter?*Please include up to 3 previous employers123Employer 1Company/Employer NameStart Date Date Format: MM slash DD slash YYYY End Date Date Format: MM slash DD slash YYYY Employer Phone NumberJob TitleJob Duties/DescriptionSupervisor's NameReason for LeavingMay we contact this employer?YesNoEmployer 2Company/Employer NameStart Date Date Format: MM slash DD slash YYYY End Date Date Format: MM slash DD slash YYYY Employer Phone NumberJob TitleJob Duties/DescriptionSupervisor's NameReason for LeavingMay we contact this employer?YesNoEmployer 3Company/Employer NameStart Date Date Format: MM slash DD slash YYYY End Date Date Format: MM slash DD slash YYYY Employer Phone NumberJob TitleJob Duties/DescriptionSupervisor's NameReason for LeavingMay we contact this employer?YesNoAdditional Employment InformationAdditional Work History (Upload File)If you have more than 3 previous employers you would like to include, please attach a PDF or Microsoft Word Document with your relevant work history. You will have the ability to upload your resume later in this application; do not include it here.Accepted file types: pdf, doc, docx.Additional Work History InformationPlease include any information that you believe would be helpful in determining your qualifications for this position. You may include significant accomplishments, previous career highlights, or any other relevant information that is not requested elsewhere in this employment application. ReferencesPlease provide three references.Reference 1Name First Last Email PhoneReference 2Name First Last Email PhoneReference 3Name First Last Email PhoneAttached DocumentsResumePlease attach a resume in PDF or Microsoft Word Document format. Files may not be larger than 50MB. Drop files here or Accepted file types: pdf, doc, docx. Consent and ReleasePlease read the following statement and indicate that you have read and understand it. If you have any questions, please contact us.Certification I hereby certify that the above information is correct and complete to the best of my knowledge and belief. I understand that, if I am employed, I will be liable to dismissal if any of the statements in my application are found to be deliberately misleading. Signature*By typing your full name below, you are providing a digital signature and attesting that the information provided is true and correct to the best of your knowledge.PhoneThis field is for validation purposes and should be left unchanged.