Employment Application - Golden Empire Transit District

I authorize all corporations, companies, former employers, credit agencies, educational institutions, law enforcement agencies, city, state, county and federal courts, military services and person to release information they may have about me to the person or company with which this form has been filed, or their agent, Trak-1 Technology, and release all parties involved from any liability and responsibility for doing so. I also authorize the procurement of an investigative consumer report and understand that it may contain information about my background, mode of living, character and personal reputation. This authorization, in original or copy form, shall be valid for this and any future reports or updates that may be requested. Further information may be available upon written request may be available upon written request within a reasonable period of time. I further understand that Golden Empire Transit District will furnish copies of any and all investigative reports that are obtained through the investigative process.
The applicant must be the one filling in and submitting this application.
Please be sure to fill in all information accurately and completely.

Check box below to agree to the above stated acknowledgement.*

I agree

Application Date*

Name*

First Last

Address*

Street Address City State ZIP Code

Email

Phone*

Have you previously been employed by Golden Empire Transit District?*

Yes
No

If yes, please give the dates:*

Format: mm/yyyy

Are you less than 18 years of age?*

Yes
No

Are you eligible to work in the United States?*

Yes
No

Social Security Number*

Date of Birth*

Driver's license number*

State*

Expiration Date*

MM

DD

YYYY

Record of Education

Please indicate any languages, other than English that you speak read or write

High School

Name and Location of School*

Grade average

Graduated*

Yes
No

Jr. College

Yes
No

Name and Location of School*

Major

Grade average

Graduated*

Yes
No

Degrees

College/University

Yes
No

Name and Location of School*

Major

Grade average

Graduated*

Yes
No

Degrees

Technical/Trade

Yes
No

Name and Location of School*

Major

Grade average

Graduated*

Yes
No

Degrees

Other

Yes
No

Name and Location of School*

Major

Grade average

Graduated*

Yes
No

Degrees

Are you currently taking any educational course?

Yes
No

If "Yes", what and where?

Record of Military Service

Have you ever served in the U.S. Armed Services?*

Yes
No

Branch*

Dates of service*

Reserve status*

Highest grade, rating or rank attained*

Draft classification*

What were your duties?*

List skills or special training.

Record of Employment

Give employment record as completely as possible for the previous ten years. Listing most recent employment first, include employed/self-employed/non-employed periods and part-time or summer work.

Have you ever been previously employed?*

Yes
No

May we contact your present employer about your qualifications?*

Yes
No

Employer Information:

Dates of employment*

format: mm/yyyy. If currently employed, use current month and year for ending date

Exact title of your position*

Reason for leaving*

Name of employer*

Telephone number of employer*

Name of Immediate Supervisor*

Address

Street Address City State ZIP Code

Description of your work*

Employer Information:

Dates of employment

format: mm/yyyy

Exact title of your position

Reason for leaving

Name of employer

Telephone number of employer

Name of Immediate Supervisor

Address

Street Address City State ZIP Code

Description of your work

Employer Information:

Dates of employment

format: mm/yyyy

Exact title of your position

Reason for leaving

Name of employer

Telephone number of employer

Name of Immediate Supervisor

Address

Street Address City State ZIP Code

Description of your work

Employer Information:

Dates of employment

format: mm/yyyy

Exact title of your position

Reason for leaving

Name of employer

Telephone number of employer

Name of Immediate Supervisor

Address

Street Address City State ZIP Code

Description of your work

Miscellaneous Information

If a necessary duty of a position:

Are you willing to work rotating shifts?*

Yes
No

Overtime?*

Yes
No

Saturdays, Sundays, or Holidays?*

Yes
No

Do you know of any reason why you might not be able to be prompt and regular in attendance?*

Yes
No

If "yes" please explain:*

What method of transportation will you use to get to work?*

Have you ever been discharged or forced to resign from a position?*

Yes
No

If "yes" please explain:*

Name any friends employed here:

Name any relatives employed here:

Have you ever been employed under a different name?*

Yes
No

If "yes" list name:*

Required only for pre-employment reference check

Please list job-related organizations, clubs, professional societies, or other associations to which you belong.

You may omit those which indicate your race, color, religion, ancestry, pregnancy, sex, national origin, age, marital or veteran status, sexual orientation, gender identity, or the presence of a non-job related medical condition or disability.

Emergency Contact Information

Please identify the individual that should be notified in case of accident or emergency.

Name*

First Last

Phone*

Address*

Street Address City State ZIP Code

Job Responsibilities

State position applied for or type of work desired:*

What hourly earnings do you expect?

Leave blank if no expectation or negotiable.

When could you start?*

If employed, you would be expected to assume certain kinds of responsibilities as listed below.

Please make your answers specific to the position you are applying for or the type of work you desire. If you cannot answer some of the questions, skip them. The interviewer will help you complete them later.

Job Knowledge: If employed, you would be responsible for having the knowledge required for your position. What specific skills or knowledge do you have that relate to the position for which you are applying?

Do you type? (Answer only if typing is a requirement of the job for which you are applying.)

Yes
No

Typing speed (wpm):

What office machines or equipment can you operate?

Answer only if office equipment operation is a requirement of the job for which you are applying.

Licenses and professional certificates:

What other kinds of skills, licenses, or professional certificates do you have?

Equipment, materials, and/or records:

If employed, you may be responsible for the equipment, materials, and/or records which would be entrusted to your care. What specific equipment, materials, and/or records, etc., have you been responsible for in the past?

Performance of others:

If employed, you may be assigned to a position in which you would be responsible for the work performance of other employees. What supervisory and/or leadership experience have you had? (Indicate the type of work and the number of persons you supervised.)

Job conditions:

If employed, you may be exposed to various environmental demands, such as dust, heat, cold weather, etc. Are there environmental demands that are difficult for you to tolerate?

Physical aptitude:

Are you able to perform the essential functions of the job for which you are applying with or without reasonable accommodation?

Other Comments

How did you hear about us?*

If Person, please list below

Occasionally an application form makes it difficult for a person to adequately summarize his or her complete background. To assist us in finding the proper position for you, use the space below to provide any additional information necessary to describe your full qualifications:

Golden Empire Transit District is an Equal Opportunity Employer. As required by law, we must record certain information to be made a part of our Affirmative Action Program.

Applicants for employment are also invited to participate in the Affirmative Action Program by reporting their status as handicapped, disabled veteran, veteran of the Vietnam era or other minority. In extending this invitation you are also advised that: (a) workers (applicants) are under no obligation to respond, but may do so in the future if they choose; (b) responses will remain confidential within the Human Resources Department; and (c) responses will be used only for the necessary information to include in our Affirmative Action Program. We are a company that values diversity. We actively encourage women and minorities to apply. Refusal to provide this information will have no bearing on your application and will not subject you to any adverse treatment.

I do not wish to participate.

What is your ethnic background?

What is your sex?

Have you served in the U.S. Military Service since 8/4/64

Do you have any physical or mental disabilities?

Attachments

Resume

Attach your resume (optional)

Driver's License

Attach a valid California driver's license (optional)

Current DMV H6 Driver Report

A current DMV H6 driver report is required for all driver and safety positions. If required and not included here, you will be required to deliver this report to GET Headquarters at a later date.

Other Relevant Attachments

Drop files here or

Include other attachments you feel are relevant to your application for this position (optional)

Acknowledgement

I authorize all corporations, companies, former employers, credit agencies, educational institutions, law enforcement agencies, city, state, county and federal courts, military services and persons to release information they may have about me to the person or company with which this form has been filed, or their agent, Kroll Background Screening, and release all parties involved from any liability and responsibility for doing so. I also authorize the procurement of an investigative consumer report and understand that it may contain information about my background, mode of living, character and personal reputation. This authorization, in original or copy form, shall be valid for this and any future reports or updates that may be requested. Further information may be available upon written request within a reasonable period of time. I further understand that Golden Empire Transit District will furnish copies of any and all investigative reports that are obtained through the investigative process.
I understand that if I am being considered for employment by this company, my references will be checked.
Any acceptance of employment will be predicated in part upon the truthfulness of the written and verbal statements contained within this Application and pre-employment process. I understand that should my employer find that any statement I have made is not truthful or that I have misrepresented or omitted information, any job extended to me may be withdrawn and, if employed, I may be subject to termination.
I authorize the National Personnel Records Center, St. Louis, Missouri, or other custodian of my military records to release to Kroll Background Screening information or photocopies of my military personnel and related medical records, or only the following information/records. The background investigations may be conducted by P·A·S Associates/P·A·S Investigations, located at 1401 19th Street, Suite 235, Bakersfield, CA 93301.
I understand that in the event I am employed with GET, the company does not guarantee employment for a specific time. I further understand that my employment with GET does not constitute any form of contract, implied or expressed, and such employment will be terminable at-will either by myself or my employer upon notice of one party to the other. My continued employment is dependent upon satisfactory performance and the continued need for my services as determined by GET.
If I am offered employment, I will, as a condition of employment, be required to submit proof of my identity and legal right to work in the U.S.
If I am offered employment, I will, as a condition of employment, furnish proof that I am over 18 years of age.
I understand that I will be required to possess a current and valid California driver’s license if my job requires me to drive in the course of my work.
I understand and agree that, if I am offered a position, it may be a conditional offer based on my successful passing of both a drug and alcohol screen and a post-offer medical examination. I agree that failure to pass the test/examination, refusal to cooperate with the administration of the test/examination, or any attempt to improperly affect the results of the test/examination will result in the withdrawal of any offer or termination of employment if already employed.
I understand and agree that, if I am offered employment, I will be required to conform to the rules and regulations of the Company and sign an Employee Handbook acknowledgment form and other documents signed by new employees which may include a background investigation authorization, a drug testing authorization, a mandatory arbitration agreement and a confidentiality agreement.
I grant GET approval, after my termination of employment to release information which it may deem appropriate regarding my employment with or termination from the organization, to anyone who has a reasonable basis for making such inquiry. So long as the information disclosed is not known by this organization to be inaccurate, this organization shall not incur legal liability of any nature in connection with the furnishing of such information.
I understand that my Application for Employment will be placed in an active status for a period of six months during which time it will be reviewed as job openings occur in my area(s) of job interest. I also understand that should I wish to continue being considered for job openings beyond the six month period, I must reapply by (a) submitting a new Application for Employment or by (b) submitting a letter requesting renewal of my Application and including an update of my qualifications (recent work history, educational achievements, etc.).
I acknowledge that I have read all of the above statements and that I understand them.

Check box below to agree to the above stated acknowledgement.*

I agree

A current DMV H6 driver report is required for all driver and safety positions. Please deliver this full H6 report via mail or hand deliver to:

Golden Empire Transit
Attn: Human Resources
1830 Golden State Ave
Bakersfield CA 93301

Alternatively, you may also fax your H6 to 661-869-6394

If the position applied for requires an H6, you will be required to send or deliver your H6 within 5 days of submitting this form. Failure to do so will render your application invalid.

Check box below to agree to the above stated acknowledgement.*

I agree

Enter your name and current date below to acknowledge that all information entered on this application is accurate and true.

Name*

First Last

Signature*

Date*

Golden Empire Transit District - Employment Application

Record of Education

High School

Jr. College

College/University

Technical/Trade

Other

Record of Military Service

Record of Employment

Employer Information:

Employer Information:

Employer Information:

Employer Information:

Miscellaneous Information

Emergency Contact Information

Job Responsibilities

Other Comments

Attachments

Acknowledgement