Treasure Valley Transit

Date of Applications: *

Position(s) Applied for *

Name *

First

Middle

Last

Phone

Current Address *

Address Line 1

Address Line 2

City

State

Zip Code

How long? *

Year/ Month

Previous Addresses *

Address Line 1

Address Line 2

City

State

Zip Code

How long? *

Year/ Month

What type of work are you seeking? *

FULL TIME
PART TIME

Circle one or both.

Do you have the legal authorization to work in the United States? *

Yes
No
Unsure

Have you evered work for Treasure Valley Transit? *

Yes
No

If yes, where and what dates? *

What location did you work at from when to when?

What was your Rate of Pay and Position? *

Reason for leaving? *

Are you currently employed? *

Yes
No

If not, how long since leaving last employment? *

Candidates are required to submit and pass a background check.

Employer Name *

Address *

Address Line 1

City

State

Zip Code

Contact Person *

Phone *

Did you drive a vehicle requiring a CDL? *

Yes
No

Start Date: *

Month/ Year

End Date: *

Month/ Year

Position Held *

Salary/Wage *

Former Employer Fax Number

Reason for Leaving: *

Have you been in a car accident within the past three years?

Yes
No

Accident record for the past 3 years or more (attach sheet if more space is needed) If none, write none.

Date of Accident?

Nature of Accident

(Head-on, Rear-end, Upset, etc. )

Fatalities

Injuries

Have you had any traffic convictions and/or forfeitures within the past three years? (not including parking violations)

Yes
No

Traffic convictions and forfeitures for the past 3 years (other than parking violations) If none, write none.

Location

Date of Conviction?

Charge

Penalty

Highest Grade Completed

Highest College Grade Completed

Last School Attended

Name and City/State

Driver License State

License Number

Class & Endorsements

Expiration Date

Have you ever been denied a license, permit, or privilege to operate a motor vehicle?

Yes
No

Has any license, permit, or privilege ever been suspended or revoked?

Yes
No

If the answer to either question above is yes, please explain:

Type of Equipment - Straight Truck

(Van, Tank, Flat, etc.)

Start Date:

End Date: