Shuttle Driver Part-Time
Resume:
APPLICATION FOR EMPLOYMENT
We are an equal opportunity employer and make employment decisions without regard to race, color, religion, sex, national origin, citizenship, age, disability or any other protected trait. No question on this application is used for the purpose of limiting or excluding any applicant from consideration for employment on any basis prohibited by local, state, or federal law. If you need an accommodation in completing this application, please notify a representative of the organization.
PERSONAL INFORMATION
Applicant Name (Last, First, Middle):
Application Date:
Email Address:
Phone No.: Address (Street, City, State, Zip Code):
Mailing Address (if different than above):
Are you legally eligible to work in the U.S.?
Yes No
How were you referred to us?
During the past seven years, have you been convicted of, or have you pleaded guilty or no contest to, a felony offense? Yes No
If yes, please attach
statement explaining
EMPLOYMENT DESIRED
Position Desired:
Earliest Date You Can
Start:
Type of Employment Desired:
Circle One: Full-Time Part-Time Temporary
Are you willing to work any of the
following?
Work overtime: Yes No
Work evening/graveyard shifts: Yes No
Work weekends: Yes No
EMPLOYMENT HISTORY (Please provide all employment information for your past three employers.) Are you presently employed? Yes No May we contact your current employer: Yes No Name of Current Employer:
Address of Current Employer:
Position Held:
Rate of Pay: Dates of Employment:
From: To:
Immediate Supervisor: Contact Number: Reason for Leaving:
Employer:
Address:
Position Held:
Rate of Pay: Dates of Employment:
From: To:
Immediate Supervisor: Contact Number: Reason for Leaving:
Eligible for Re-Hire: Yes No
Revised 11-22-19 2 P a g e
Employer:
Address:
Position Held:
Rate of Pay: Dates of Employment:
From: To:
Immediate Supervisor: Contact Number: Reason for Leaving:
Eligible for Re-Hire: Yes No
EDUCATIONAL HISTORY
Name and Location of School Number of
Years Attended
Degree or Years Completed
OTHER SKILLS AND QUALIFICATIONS
Summarize any job-related training, skills, knowledge, licenses, certifications, and any other information you believe is relevant to your qualifications for this job (use more paper, if necessary): REFERENCES (Please list three references not related to you, whom you have known for at least one year.) Name Phone Number Years Acquainted
EMERGENCY CONTACTS (Name two people we may contact in case of Emergency) Name Relation Phone Number
AUTHORIZATION FOR BACKGROUND CHECK
Pursuant to the federal Fair Credit Reporting Act, I hereby authorize ServiceMaster Commercial Cleaning by Legacy (the “Company”) and its designated agents and representatives to conduct a comprehensive review of my background through a consumer report and/or an investigative consumer report to be generated for employment, promotion, reassignment or retention as an employee. I understand that the scope of the consumer report/investigative consumer report may include, but is not limited to, the following areas: verification of Social Security number; current and previous residences; employment history, including all personnel files; education; references; credit history and reports; criminal history, including records from any criminal justice agency in any or all federal, state or county jurisdictions; birth records; motor vehicle records, including traffic citations and registration; and any other public records. I authorize the complete release of these records or data pertaining to me that an individual, company, firm, corporation or public agency may have. I hereby authorize and request any present or former employer, school, police department, Revised 11-22-19 3 P a g e
financial institution or other persons having personal knowledge of me to furnish the information to the Company or its designated agents with any and all information in their possession regarding me in connection with an application of employment. I am authorizing that a photocopy of this authorization be accepted with the same authority as the original.
I understand that, pursuant to the federal Fair Credit Reporting Act, if any adverse action is to be taken based upon the consumer report, a copy of the report and a summary of the consumer’s rights will be provided to me. I have read and fully understand the foregoing statements regarding Authorization for Background Check and I seek employment under the conditions set forth above. Signature of Applicant Date
DRUG AND/OR ALCOHOL TESTING CONSENT
I hereby agree, upon a request made under the drug/alcohol testing policy of ServiceMaster Commercial Cleaning by Legacy (the “Company”), to submit to a drug or alcohol test and to furnish a sample of my urine, breath, and/or blood for analysis. I understand and agree that if at any time I refuse to submit to a drug or alcohol test under Company policy, or if I otherwise fail to cooperate with the testing procedures, I will be subject to immediate termination. I further authorize and give full permission to have the Company and/or its Company physician send the specimen or specimens so collected to a laboratory for a screening test for the presence of any prohibited substances under the policy, and for the laboratory or other testing facility to release any and all documentation relating to such test to the Company and/or to any governmental entity involved in a legal proceeding or investigation connected with the test. I authorize the Company to disclose any documentation relating to such test to any governmental entity involved in a legal proceeding or investigation connected with the test.
I understand that only duly-authorized Company officers, employees, and agents will have access to information furnished or obtained in connection with the test; that they will maintain and protect the confidentiality of such information to the greatest extent possible; and that they will share such information only to the extent necessary to make employment decisions and to respond to inquiries or notices from government entities. I will hold harmless the Company, its Company physician, and any testing laboratory the Company might use, meaning that I will not sue or hold responsible such parties for any alleged harm to me that might result from such testing, including loss of employment or any other kind of adverse job action that might arise as a result of the drug or alcohol test, even if a Company or laboratory representative makes an error in the administration or analysis of the test or the reporting of the results. I will further hold harmless the Company, its company physician, and any testing laboratory the Company might use for any alleged harm to me that might result from the release or use of information or documentation relating to the drug or alcohol test, as long as the release or use of the information is within the scope of this policy and the procedures as explained in the paragraph above. This policy and authorization have been explained to me in a language I understand, and I have been told that if I have any questions about the test or the policy, they will be answered. I UNDERSTAND THAT THE COMPANY MAY REQUIRE A DRUG SCREEN AND/OR ALCOHOL TEST UNDER THIS POLICY WHENEVER I AM INVOLVED IN AN ON-THE-JOB ACCIDENT OR INJURY UNDER CIRCUMSTANCES THAT SUGGEST POSSIBLE INVOLVEMENT OR INFLUENCE OF DRUGS OR ALCOHOL IN THE ACCIDENT OR INJURY EVENT, AND I AGREE TO SUBMIT TO ANY SUCH TEST. I have read and fully understand the foregoing statements regarding Drug and/or Alcohol Testing and I seek employment under the conditions set forth above. Signature of Applicant Date
Contact this candidate