Star Transit Employment Application
Print Application Form and Mail To:
PO Box 703, 200 S. Virginia, Terrell, TX 75160
Or
Drop off Application at the Old Train Depot Located at:
200 S. Virginia, Terrell, TX 75160
APPLICATION FOR EMPLOYMENT
BACKGROUND CHECKS
STAR TRANSIT will conduct a full background check on all candidates for employment.
PLEASE COMPLETE AND SIGN THE SEPARATE NOTIFICATION FORM
DRUG SCREENING
STAR TRANSIT is committed to maintaining a “0” tolerance DRUG FREE workplace. All offers of employment are contingent upon successful completion of a pre-employment drug screen.
PLEASE COMPLETE AND SIGN THE SEPARATE NOTIFICATION FORM
Thank you for considering applying for a position with STAR TRANSIT. We appreciate the time you are giving to complete this application form. It is important that you fully and accurately complete this form yourself and indicate the position(s) for which you wish to be considered. Please be very careful completing this application. We use a sophisticated and detailed background and employment screening process in which will disclose inaccurate, false, and/or incomplete or omitted information. This application will remain on file for 180 days from the date herein whereupon you should resubmit a new application if you are interested in a position with STAR TRANSIT.
The following must be filled out completely for your application to be considered.
PERSONAL INFORMATION: [Please Print]
First Name: Last Name: Middle:
______________________________________________________________________________________
Have you ever used another name? Yes ____ No _____ List all other names by which you have been known: _______________________________________________________________________________________
Position you are applying for: _______________________________________________________________
Present Address: _______________________________________________________________________________________
Street City State Zip
Mailing Address: [If different]
____________________________________________________________________________________
Street City State Zip
Business Telephone (____) __________________ Home Telephone (____) __________________
Social Security-(Last 4) # xxx -xx-____________
Have you ever used another Social Security Number? Yes _____ No _____
Please list the cities and corresponding state you have lived in during the past 7 years: 1____________________________________________________________________
2 ___________________________________________________________________
3____________________________________________________________________
Do you have a valid driver’s license? Yes _____ No _____ If so, what state: ________________
Driver’s License# ___________________
Have you been a licensed driver for the last 5 years? Yes _____ No _____
List all moving violations and accidents in the past three years:
____________________________________________________________________________________
____________________________________________________________________________________
Drivers License classification: C _______ CDL-C ________ CDL-B _______ CDL-A ________
List Endorsements:_________________________________________________________
Have you ever been convicted for driving under the influence (DUI)? Yes _____ No _____
If hired, would there be anything preventing you from working as scheduled? Yes _____ No _____
If hired, can you present evidence of your U.S. citizenship or proof of your legal right to live and work in this country? Yes _____ No _____ (Note: Proof of age and eligibility for employment will be required if you are hired.)
Have you ever been terminated or asked to resign from a job? Yes _____ No _____
Please explain: __________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
If hired, on what date can you start work: ____________ Full Time ______ Part Time ______
What days and hours are you available for work? ____________________________________________________________________________________
Circle the days you would be available:
Monday Tuesday Wednesday Thursday Friday Saturday Sunday Holidays
What are the times you would not be available to work? ____________________________________________________________________________________
Would you be available to work overtime, if necessary? Yes _____ No _____
Have you ever applied to or worked for STAR TRANSIT? Yes _____ No _____If yes, when? ______________________________________________________________________
Do you have any friends or relatives working for STAR TRANSIT? Yes _____ No _____
If yes, state name(s) and relationships: _____________________________________________________________________________________
Do you have any commitment to another entity or person that might affect your employment with STAR TRANSIT?
Yes _____ No _____ If yes, describe fully: ____________________________________________________________________________________
____________________________________________________________________________________
REFERNCES: How were you referred to our Company? Newspaper _____Walk In_____ Internet______ Texas Workforce Commission _______ Employee Referral (Name:___________________)
Other: ____________________________
List below three persons not related to you who have knowledge of your work performance within the last three years. If this does not apply to you, then provide three school or personal references that are not related to you.
Name Address Phone Years Known
1. __________________________________________________________________________________
2. __________________________________________________________________________________
3. __________________________________________________________________________________
EDUCATION, TRAINING AND EXPERIENCE:
School Name and Address, Completed Diploma, or Graduate?
High School ____________________________________________ Graduate? Yes _____ No _____
College/University _____________________________________ Graduate? Yes _____ No _____
Vocational/Business_____________________________________ Graduate? Yes _____ No _____
Some of our customers/clients may not speak English. Do you speak, write or understand any other languages? Yes _____ No _____
If yes, which language(s): ________________________________________________________
Do you have any other experience, training, qualifications or skills, which you feel may make you especially suited for work at STAR TRANSIT? Yes _____ No _____ If, yes, please list: _________________________________________________________________________________________
__________________________________________________________________________________________
Managerial Skills: Yes _____ No _____
Typing: Yes _____ No _____ Speed: ______WPM ______
Basic Computer Knowledge: Yes _____ No _____
Internet: Yes _____ No _____
Spreadsheets: Yes _____ No _____
Graphics/Design: Yes _____ No _____
MS Word: Yes _____ No _____
Database: Yes _____ No _____
Other Programs: Yes _____ No _____ Specify: _____________________________________________
List any computer programs with which you are familiar: ____________________________________________________________________________________
___________________________________________________________________________________
EMPLOYMENT HISTORY: List below all present and past employment starting with your most recent employer. You must complete this section even if attaching a resume. (Note: Attach additional page(s) if necessary)
Are you employed now? Yes _____ No _____
If Yes, may we contact your present employer? Yes _____ No _____
- Name of Employer: _______________________________________________________
- Type of Business: _____________
Address:______________________________________________________________________________
No. Street City State Zip
Telephone (_____) _________________ Your Supervisor's Name: ________________________________
Your Position and Duties: _________________________________________________________________
Date of Employment: From ____/_____/______ To ____/_____/______
Ending wage _____________ Hourly ____________ Monthly ____________________
Did you operate a Commercial Motor Vehicle on this job? Yes _____ No _____
Was termination voluntary or involuntary? Vol __________ In Vol __________
Exact Reason for Leaving: ______________________________________________________________________________________
______________________________________________________________________________________
- Name of Employer: __________________________________ Type of Business:____________
Address:_______________________________________________________________________________
Street City State Zip
Telephone No. (_____) _________________ Your Supervisor's Name: ___________________________
Your Position and Duties: _______________________________________________________________
Date of Employment: From ____/_____/______ To ____/_____/______
Ending wage _____________ Hourly ____________ Monthly ____________________
Did you operate a Commercial Motor Vehicle on this job? Yes _____ No _____
Was termination voluntary or involuntary? Vol __________ In Vol __________
Exact Reason for Leaving: _______________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
- Name of Employer: ______________________________ Type of Business: _______________
Address:_____________________________________________________________________________
Street City State Zip
Telephone (_____) _________________ Your Supervisor's Name: ____________________________
Your Position and Duties: _______________________________________________________________
Date of Employment: From ____/_____/______ To ____/_____/______
Ending wage _____________ Hourly ____________ Monthly ____________________
Did you operate a Commercial Motor Vehicle on this job? Yes _____ No _____
Was termination voluntary or involuntary? Vol __________ In Vol __________
Exact Reason for Leaving: _________________________________________________________________________________________
UNEMPLOYMENT HISTORY: Please account for any time(s) you were not employed in the last 10 years after leaving school. You do not need to include periods of one month or less. (Note: Attach additional page(s) if necessary.)
Time Period: Reason(s) Unemployed:
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
MILITARY SERVICE:
Were you ever in the Armed Services? _______Yes _______ No If so, what branch? ________________
Dates of Duty: From: ____/____/_______ To: ____/____/_______
Have you obtained any special skills or abilities as a result of service in the military? _____Yes _____ No
If yes, describe:_________________________________________________________________________
_ ____________________________________________________________________________________
Have you in the last 7 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? Yes _____ No _____
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? Yes _____ No _____
If yes, explain each conviction fully, when, where and of what you were convicted and disposition of the case(s): _________________________________________________________________________________________
_________________________________________________________________________________________
Are you currently under arrest, or released on bond or your own recognizance, pending trial for a criminal offense? Yes _____ No _____
If yes, state the nature of the crime charged, and when and where trial is pending: __________________________________________________________________________________________
__________________________________________________________________________________________
(Note: No applicant will be denied employment solely on the grounds that they have been charged, committed or been convicted [or pleaded guilty or nolo contendere] of a criminal offense; or, solely on an affirmative answer above).
Are you able to perform the essential functions of the job for which you are applying with or without reasonable accommodation, including bending, lifting, pushing, pulling? Yes _____ No _____ If no, describe the functions that cannot be performed: _________________________________________________________________________________________
_________________________________________________________________________________________
Is there any reason why you would not be able to fully conform to all attendance requirements?
Yes _____ No _____
Describe fully: (Note: We comply with the ADA and provide reasonable accommodation measures that may be necessary for eligible applicants/employees to perform essential functions. Hire may be subject to passing a medical examination, and to skill and agility tests.)
NOTICE: Thank you for completing this application form. If there is a current opening in the position(s) you are seeking and the information in your application suggests you meet the minimum qualifications and are among the best qualified candidate for that position, you may be contacted for an interview. If you are interviewed, you will be informed of a final decision once the entire interview process is completed which includes a complete background check and pre-employment drug test. If there is no opening in the position(s) you are seeking, your application will be kept active for 180 days. If you wish to be considered for employment after that time, you must reapply. Thank you for your interest in our company. Please read page six carefully, print your name, initial, sign, and date.
AUTHORIZATION
PLEASE READ THE FOLLOWING CAREFULLY, INITIAL EACH PARAGRAPH, THEN SIGN BELOW. PLEASE COMPLETE AND SIGN ANY SEPARATE DOCUMENTS WHICH MAY BE ATTACHED.
PERSONALLY COMPLETED FORM HONESTLY AND ACCURATELY
BY MY SIGNATURE AND INITIALS PLACED BELOW, I PROMISE THAT I HAVE PERSONALLY COMPLETED THIS APPLICATION. I DECLARE UNDER PENALTY OF PERJURY THAT THE INFORMATION PROVIDED IN THIS EMPLOYMENT APPLICATION (AND ACCOMPANYING RESUME, IF ANY) IS TRUE AND COMPLETE, AND I UNDERSTAND THAT ANY FALSE INFORMATION OR SIGNIFICANT OMISSIONS MAY DISQUALIFY ME FROM FURTHER CONSIDERATION FOR EMPLOYMENT, AND MAY BE JUSTIFICATION FOR MY DISMISSAL FROM EMPLOYMENT IF DISCOVERED AT A LATER DATE). I UNDERSTAND THAT ANY JOB OFFER WILL BE CONDITIONAL BASED ON THE SATISFACTORY REVIEW OF MY QUALIFICATIONS INCLUDING ANY AND ALL BACKGROUND OR DRUG SCREENING, WHICH MAY BE REQUIRED. ___________ INITIALS
DRUG & ALCOHOL SCREENING
IF THE COMPANY MAKES A CONDITIONAL JOB OFFER, I GIVE PERMISSION FOR A PHYSICAL EXAMINATION INCLUDING A PREEMPLOYMENT DRUG SCREEN. RESULTS WILL BE HELD IN CONFIDENCE BY STAR TRANSIT EXCEPT WHERE RELEASE OF SUCH INFORMATION IS REQUIRED BY LAW. ___________ INITIALS
OTHER EMPLOYMENT
I UNDERSTAND THAT, IF HIRED, I MAY NOT HOLD OTHER EMPLOYMENT OR ENGAGE IN OTHER ACTIVITIES THAT CREATE A CONFLICT OF INTEREST WITH MY POSITION WITH THE COMPANY UNLESS I HAVE BEEN GIVEN PERMISSION IN WRITING BY THE COMPANY. ____________ INITIALS
AUTHORIZATION TO OBTAIN INFORMATION
I VOLUNTARILY AND KNOWINGLY AUTHORIZE ANY PAST EMPLOYER; EDUCATIONAL INSTITUTION; LAW ENFORCEMENT AGENCY; STATE, LOCAL, OR FEDERAL AGENCY; MILITARY BRANCH; THE NATIONAL PERSONNEL RECORDS CENTER; PERSONAL REFERENCE; AND/OR OTHER PERSONS; TO GIVE RECORDS OR INFORMATION THEY MAY HAVE CONCERNING MY CRIMINAL HISTORY, MOTOR VEHICLE RECORD, AND EDUCATIONAL HISTORY, LICENSING, EMPLOYMENT (INCLUDING CHARACTER, EARNINGS HISTORY AND REASONS FOR TERMINATION) OR ANY OTHER INFORMATION REQUESTED BY STAR TRANSIT TO DETERMINE MY ELIGIBILITY FOR EMPLOYMENT. ____________ INITIALS
RELEASE
I VOLUNTARILY WAIVE ALL RECOURSE AND RELEASE ANY COMPANY, INDIVIDUAL OR ORGANIZATION FROM LIABILITY FOR COMPLYING WITH ANY REQUEST FROM THE COMPANY OR AGENTS OF THE COMPANY (INCLUDING ANY CONSUMER REPORTING AGENCY) TO OBTAIN ANY INFORMATION FROM ANY SOURCE WHATSOEVER RELATING TO MY APPLICATION FOR EMPLOYMENT. I FURTHER RELEASE THE COMPANY OR ANY INDIVIDUAL WITHIN THE COMPANY REGARDING THE USE ANY INFORMATION RECEIVED WHICH MAY HAVE BEARING ON MY APPLICATION FOR EMPLOYMENT.____________ INITIALS
NOTIFICATION & COMPLIANCE WITH RULES
I AGREE TO IMMEDIATELY NOTIFY STAR TRANSIT IF I SHOULD BE CONVICTED OF A CRIME WHILE MY JOB APPLICATION IS PENDING, OR DURING MY EMPLOYMENT IF HIRED. IF I BECOME EMPLOYED, IN CONSIDERATION OF MY EMPLOYMENT, I AGREE TO COMPLY WITH THE RULES, REGULATIONS, POLICIES AND PROCEDURES OF STAR TRANSIT. ___________ INITIALS
AGREEMENT FOR ATWILL EMPLOYMENT
I UNDERSTAND AND AGREE THAT NOTHING CONTAINED IN THIS APPLICATION, OR CONVEYED DURING ANY INTERVIEW WHICH MAY BE GRANTED, OR DURING MY EMPLOYMENT IF HIRED, IS INTENDED TO CREATE AN EMPLOYMENT CONTRACT WITH STAR TRANSIT. IN ADDITION, I UNDERSTAND AND AGREE THAT IF YOU EMPLOY ME, IN CONSIDERATION OF MY EMPLOYMENT, MY EMPLOYMENT WILL BE ATWILL, FOR NO DEFINITE OR DETERMINABLE PERIOD OF TIME, AND MAY, REGARDLESS OF THE DATE OF PAYMENT OF MY WAGES OR SALARY, BE TERMINATED AT ANY TIME, FOR ANY REASON OR FOR NO REASON AT ALL, WITH OR WITHOUT PRIOR NOTICE, AT THE OPTION OF STAR TRANSIT OR ME. I UNDERSTAND AND AGREE THAT NO PROMISES OR REPRESENTATIONS CONTRARY TO THE FOREGOING ARE BINDING ON STAR TRANSIT UNLESS MADE IN WRITING AND SIGNED BY ME AND AN AUTHORIZED OFFICER OF STAR TRANSIT. I PROMISE THAT I HAVE NOT RELIED, AND WILL NOT RELY, ON ANY ORAL OR WRITTEN STATEMENTS TO THE CONTRARY. I UNDERSTAND AND AGREE THAT THIS IS THE ENTIRE AGREEMENT BETWEEN STAR TRANSIT AND ME REGARDING THE TERM OF MY EMPLOYMENT AND REPLACES ANY OTHER ORAL OR WRITTEN AGREEMENT OR UNDERSTANDING. ____________ INITIALS
I certify that all of the information provided by me on this Application is true and accurate.
Signature: _________________________________________ Date: ________________
Printed Name: _________________________________________
STAR TRANSIT IS AN EQUAL OPPORTUNITY EMPLOYER. IT IS THE POLICY OF THIS COMPANY TO CONSIDER ALL JOB APPLICATIONS ON THE BASIS OF MERIT WITHOUT REGARD TO RACE, COLOR, RELIGION, SEX, AGE, NATIONAL ORIGIN, ANCESTRY, MARITAL STATUS, DISABILITY OR ANY OTHER PROTECTED CHARACTERISTIC.
STAR TRANSIT OPERATOR APPLICANT
Release of Information Form
Section I. To be completed by the new employer, signed by the employee, and transmitted to the previous employer
Potential Employee Printed or Typed Name:
Potential Employee SS or ID Number:
I hereby authorize release of information from my U. S. Department of Transportation (USDOT)-regulated drug and alcohol testing records by my previous employer to the employer listed. I understand that information to be released by my previous employer, is limited to the following USDOT-regulated testing items:
1. Alcohol tests with a result of 0.04 or higher;
2. Verified positive drug tests;
3. Refusals to be tested;
4. Other violations of USDOT agency drug and alcohol testing regulations;
5. Information obtained from previous employers of a drug or alcohol rule violation;
6. Documentation, if any, of completion of the return-to-duty process following a rule violation.
Employee Signature: __________________________________________________
Date: ____________________
Employer Name:
Address:
Phone #: Fax #:
Designated Employer Representative:
Previous Employer Name:
Address:
Phone #:
Designated Employer Representative (if known):
Section II. To be completed by the previous employer and transmitted by mail or fax to the new employer
In the two years prior to the date of the employee’s signature (in Section I), for USDOT-regulated testing:
1. Did the employee have alcohol tests with a result of 0.04 or higher? YES ____ NO ____
2. Did the employee have verified positive drug tests? YES ____ NO ____
3. Did the employee refuse to be tested? YES ____ NO ____
4. Did the employee have other violations of USDOT agency drug and
alcohol testing regulations? YES ____ NO ____
5. Did a previous employer report a drug and alcohol rule violation
to you? YES ____ NO ____
6. If you answered “yes” to any of the above items, did the
employee complete the return-to-duty process? N/A ____ YES ____ NO ____
NOTE: If you answered “yes” to item 5, you must provide the previous employer’s report. If you answered “yes” to item 6, you must transmit the appropriate return-to-duty documentation (e.g., SAP report(s), follow-up testing record).
Former employer contact information.
Name of person providing information in Section II-A: ____________________________________________
Title: ________________________________ Phone: ____________________ Date: _________________
STAR TRANSIT Equal Employment Opportunity Information
The Equal Employment Office of the Federal Transit Administration (FTA) has asked all transit authorities to gather information on job applicants. You can assist the STAR TRANSIT EEO Office by supplying the information requested on this sheet.
COMPLETION OF THESE QUESTIONS IS COMPLETELY VOLUNTARY AND IN NO WAY AFFECTS YOUR APPLICATION FOR EMPLOYMENT.
Please check the appropriate box and fill in the information requested.
A. Ethnic Origin
___White
___Black
___Hispanic/Spanish Surname
___Asian
___American Indian
___Other
B. Gender
___Male
___Female
C. Date of Birth Month_______ Day _______ Year _______
D. Position Applied For:
Bus Operator _____; Other please specify___________________________
E. Date Submitting Application: Month _____ Day _____ Year _____
F. I choose not to provide this information _____ Initials _____
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877.631.5278
