JATA Employment Application

APPLICATION FOR EMPLOYMENT

The Jackson Area Transportation Authority is an Equal Opportunity Employer. We consider applicants for all positions without regard to race, color, religion, sex, national origin, age, marital status, the presence of non-job related medical condition, or disability, or any other legally protected status.
Date you are available to begin working*
MM slash DD slash YYYY
Name*
First Middle Last
Address*
Street Address Address Line 2 City State ZIP Code
Personal Phone*
Email*
Are you 21 or older?*
- Yes
- No
Position you are applying for*
Are you applying for*
- Full time work
- Part time work
- Temporary work
Can you perform all the functions of the job you are applying for with or without accommodation?*
- Yes
- No
Would you be able to work any day of the week including weekends and evenings?*
- Yes
- No
Have you previously been employed by this transportation system, or by a local unit of government in this county?*
- Yes
- No
If yes, please specify*
Who were you employed with? What was your job title? What was your date of employment?
Do you have any relatives currently employed with this transportation system?*
- Yes
- No
Are you currently on "lay-off" status and subject to recall?*
- Yes
- No
Hourly rate expected/desired:*
EDUCATION
High School
City/State
Diploma
- Yes
- No
Vocational School
City/State
Diploma
- Yes
- No
College
City/State
Degree/Major
Graduate School
City/State
Degree/Major
Specialized Training
City/State
Fields
Have you had experience with, or training in the following areas?*
- CPR
- Safety
- Computers
- First Aid
- Working with the disabled
- Vehicle repair
- Defensive driving
- Elder care
- Management
- Other
- No
Are you engaged in or planning any further education, training or study?*
- Yes
- No
PAST EMPLOYMENT. PLEASE BEGIN WITH THE MOST CURRENT/RECENT
EMPLOYMENT 1
Employer*
Job Title*
Phone*
Address*
Street Address Address Line 2 City State ZIP Code
Start Date*
Month
Day
Year
End Date*
Month
Day
Year
Starting Hourly Rate*
Ending Hourly Rate*
Work performed*
Reason for leaving*
EMPLOYMENT 2
Employer
Job Title
Phone
Address
Street Address Address Line 2 City State ZIP Code
Start Date
Month
Day
Year
End Date
Month
Day
Year
Starting Hourly Rate
Ending Hourly Rate
Work performed
EMPLOYMENT 3
Employer
Job Title
Phone
Address
Street Address Address Line 2 City State ZIP Code
Start Date
Month
Day
Year
End Date
Month
Day
Year
Starting Hourly Rate
Ending Hourly Rate
Work performed
Reason for leaving
EQUIPMENT/MAINTENANCE SKILLED LABOR POSITIONS ONLY
Please check those skills which you could use immediately on the job.
MECHANIC
- Brake re-line
- Electronic systems
- Automotive electrical systems
- Engine tune-up
- Engine repair & overhaul (gas)
- Lube, oil change
- Engine repair/overhaul (diesel)
PAINTER
- Metal finish painting
- Lettering
- Paint spray gun
- Other
BODY REPAIR
- Frame straightening
- Welding/torch usage (ARC, MIG, TIG, Plasma)
AIR CONDITIONING & HEATING
- Compressors
- Repairs
- Installation
- Other
BUILDING & GROUNDS EQUIPMENT
- Back hoe
- Hi-lo machine
- Fork lift
- Pneumatics & hydraulics
- Floor scrubber
- Electrical
- Hydraulic sign post puller
- Pneumatic air hammer
- Boiler maintenance
- Other
FOR MANAGEMENT & GENERAL OFFICE POSITIONS ONLY
Please check all the skills you could use on the job immediately
Skills
- Typing
- Accounting
- Calculator
- Inventory
- Bookkeeping
- Payroll
- Computers (please specify programs used)
SPECIAL QUALIFICATIONS
Briefly describe job related skills and qualifications from employment or other experiences, which you believe will assist us in deciding if and when we can employ your services:
DRIVING POSITIONS ONLY
Driver's License Program
Do you presently have a valid Michigan Drivers License?*
- Yes
- No
Do you have a valid commercial drivers license?*
- Yes
- No
Group
- A
- B
- C
Endorsement
- P
- X
- T
- N
Type
- C
- O
How many moving violation points do you currently have against your drivers license?*
Do you currently have any restrictions on your drivers license?*
- Yes
- No
If yes, please explain
Has your drivers license ever been suspended or revoked? Or has it been restricted regarding when and for what purpose you could drive?*
- Yes
- No
If yes, please explain
SPECIALIZED DRIVING EXPERIENCE
Have you operated any o the following types of vehicles?
- Transit bus
- Para transit van
- School bus
- Wrecker
- Trucker
- Private carrier bus
- Tractor trailer
Give dates you operated each vehicle type
Give the employers whom you operated the different vehicle types for
Have you ever operated a vehicle used to transport disabled and/or senior citizens?*
- Yes
- No
Did you receive any specialized training for this work? If so, please briefly describe the training*
Do you have experience operating a hydraulic lift on a transit vehicle?*
- Yes
- No
Have you received any passenger sensitivity training?*
- Yes
- No
ACCIDENT HISTORY
How many accidents have you been in regardless of severity?*
List all accidents you have been involved in within the past five years; with the most recent first:
Date of accident*
MM slash DD slash YYYY
City & State*
Brief description of accident*
Were you cited?*
- Yes
- No
Date of accident*
MM slash DD slash YYYY
City & State*
Brief description of accident*
Were you cited?*
- Yes
- No
Date of accident*
MM slash DD slash YYYY
City & State*
Brief description of accident*
Were you cited?*
- Yes
- No
Date of accident*
MM slash DD slash YYYY
City & State*
Brief description of accident*
Were you cited?*
- Yes
- No
Date of accident*
MM slash DD slash YYYY
City & State*
Brief description of accident*
Were you cited?*
- Yes
- No
How many accidents have you had as an operator of a commercial vehicle?*
How many accidents have you had as an operator of a private car?*
TRAFFIC VIOLATIONS
How many traffic violations have you had in the past 5 years?*
Date of violation*
MM slash DD slash YYYY
Infraction/Offense*
City/State*
Disposition/Fine*
Date of conviction*
MM slash DD slash YYYY
Date of violation*
MM slash DD slash YYYY
Infraction/Offense*
City/State*
Disposition/Fine*
Date of conviction*
MM slash DD slash YYYY
Date of violation*
MM slash DD slash YYYY
Infraction/Offense*
City/State*
Disposition/Fine*
Date of conviction*
MM slash DD slash YYYY
Date of violation*
MM slash DD slash YYYY
Infraction/Offense*
City/State*
Disposition/Fine*
Date of conviction*
MM slash DD slash YYYY
Date of violation*
MM slash DD slash YYYY
Infraction/Offense*
City/State*
Disposition/Fine*
Date of conviction*
MM slash DD slash YYYY
REFERENCES
Please provide contact information for three people whom you have known for at least one year. (Please do not include relatives)
Name
Reference 1
First Last
Phone
Address
Street Address Address Line 2 City State ZIP Code
Employed by
Name
Reference 2
First Last
Phone
Address
Street Address Address Line 2 City State ZIP Code
Employed by
Name
Reference 3
First Last
Phone
Address
Street Address Address Line 2 City State ZIP Code
Employed by
GENERAL INFORMATION
Aproximately how many times have you been absent (other than vacations, holidays, extended medical leaves etc.) or late for work during the past two years?*
Have you ever been convicted of a felony or misdemeanor?*
- Yes
- No
Please describe and provide: Date of offense, Nature of offense, City/State, Penalty/fine.
Do you presently have any felony or misdemeanor charges pending against you?*
- Yes
- No
If yes, please explain
The Jackson Area Transportation Authority is an Equal Opportunity Employer. Qualified applicants are considered for positions without regard to race, color, religion, gender, national origin, age, marital or veteran status, or disability. Solely, to help us comply with government record-keeping, reporting and other legal requirements, please complete this data record. This data is for statistical purposes only and will be kept in a confidential file separate from the employment application.

You are not required to complete this information to be considered for employment.
Date
MM slash DD slash YYYY
Position(s) applied for
APPLICATION STATEMENT
Approve or disapprove*
Let the following choice certify that the answers given herein are true and complete to the best of my knowledge. I authorize investigation of all statements contained in this application for employment, as may be necessary in arriving at an employment decision. If offered employment, I consent to take a complete medical examination, and such future medical examinations as may be required, including, but not limited to, drug testing. If hired, in consideration of my employment, I agree to abide by the rules and policies of the employer. I further agree that, in the absence of any contractual agreement to the contrary, my employment and all compensation can be terminated with or without cause, and with or without prior notice, at any time, at the option of either the employer or me. I understand that no agent or representative of the employer has any authority to make any agreement contrary to the foregoing, except by a written employment contract signed by the General Manager of the Jackson Area Transportation Authority (JATA). In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in my discharge.
- Approve
- Disapprove
Date*
MM slash DD slash YYYY
AUTHORIZATION
Authorization*
I hereby authorize the release of any and all employment, education, civil, criminal or other records, which may be required to evaluate my eligibility for employment, to the management of JATA.
- I authorize said above
- I do not authorize said above
Date*
MM slash DD slash YYYY
Address*
Street Address Address Line 2 City State ZIP Code
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APPLICATION FOR EMPLOYMENT

EDUCATION

PAST EMPLOYMENT. PLEASE BEGIN WITH THE MOST CURRENT/RECENT

EMPLOYMENT 1

EMPLOYMENT 2

EMPLOYMENT 3

EQUIPMENT/MAINTENANCE SKILLED LABOR POSITIONS ONLY

FOR MANAGEMENT & GENERAL OFFICE POSITIONS ONLY

DRIVING POSITIONS ONLY

SPECIALIZED DRIVING EXPERIENCE

ACCIDENT HISTORY

TRAFFIC VIOLATIONS

REFERENCES

GENERAL INFORMATION

APPLICATION STATEMENT

AUTHORIZATION