THANK YOU FOR YOUR INTEREST IN COUNTY CONNECTION

Transcription

1 THANK YOU FOR YOUR INTEREST IN COUNTY CONNECTION THIS COVER CONTAINS IMPORTANT INFORMATION PLEASE READ IT CAREFULLY BEFORE COMPLETING THE APPLICATION To be considered for employment with County Connection, all applicants must meet the following requirements: 1. Your application must be legible and complete 2. Most positions require that you be able to read, write, speak, and understand English 3. You must have a stable, verifiable job history which includes the skills and work experience necessary for the position which you are applying to 4. You must successfully compete in a personal interview To be considered for the Transit Operator Training Program, all applicants must meet the following requirements in addition to those listed in the first section: 1. You must be at least 18 years of age 2. You must have a valid California driver s license and a good driving record. A current Department of Motor Vehicles (DMV) H 6 printout that is less than thirty (30) days old must be attached to your application in order to be considered. A good driving record is one that: a. Has no convictions for driving under the influence of alcohol or drugs; b. Has no warrants for failures to appear; c. Is accident free; d. Has no more than two (2) points or moving violations; e. Has no incident of negligent, careless, or reckless driving 3. You must successfully complete the Department of Transportation s (DOT) physical exam and pre employment drug screening for illegal substances. Please note that in accordance with Federal mandates, County Connection is required to conduct random selection testing of safety sensitive employees for illegal substances and prohibited use of alcohol. 4. You must be able to obtain a Class B Commercial driver s permit To be considered for employment in the Maintenance Department, all applicants must meet the following requirements in addition to those listed in the first section: 1. You must have a valid California driver s license and a good driving record. Applicants for Mechanic or Service Worker positions must be at least 18 years of age and attach a current Department of Motor Vehicles (DMV) H 6 printout that is less than thirty (30) days old in order to be considered. Applicants for these positions must also be able to obtain a Class B Commercial driver s permit and, within ninety (90) days of hire, a Class B license. 2. You must successfully complete the Department of Transportation s (DOT) physical exam and pre employment drug screening for illegal substances. Please note that in accordance with Federal mandates, County Connection is required to conduct random selection testing of safety sensitive employees for illegal substances and prohibited use of alcohol. Candidates who meet the minimum requirements will be notified of the interview process. Employment applications are kept in our active files for one (1) year. Please advise us if your contact information changes within that time. County Connection is an Equal Opportunity Employer and Drug Free Workplace

2 CENTRAL CONTRA COSTA TRANSIT AUTHORITY IS AN EQUAL OPPORTUNITY EMPLOYER PLEASE READ CAREFULLY This is a confidential employment application. Please answer all questions as completely and accurately as possible. Failure to complete this form thoroughly may result in disqualification of your application. If a question does not apply, put N/A (not applicable) in the place of an answer. PLEASE PRINT IN INK OR TYPE Name (First, M, Last) Date Street Address I am available to work: (check applicable boxes) City State Home Phone Cell Phone Full-time Zip Part-time Days/hours available: Either Full-time or Part-time If hired, can you furnish: Proof of U.S. Citizenship or authorization to work in the U.S.? Regular Temporary For how long? Position(s) applied for: Either regular or temporary Days available to work: Date available for work: Monday Tuesday CCCTA is required by Federal mandate to perform drug and alcohol tests on all employees performing safety sensitive functions. This includes random selection testing. Thursday Friday Shift(s) available to work: The hiring process may involve interview(s), timed written test(s) and job demonstration(s). Please advise Human Resource personnel prior to the interview or test if you need a reasonable accommodation for this process. Available for overtime? Day Wednesday Saturday Swing Sunday Grave If yes, when? CCCTA policy generally restricts concurrent employment of immediate family members of employees, consultants or board members. Immediate family includes spouse, children, parents, grandparents, brother, sister, or legal guardian, and the children, parents, grandparents, brother, sister, or legal guardian of the spouse. Does CCCTA currently employ any of your immediate Have you ever applied to CCCTA previously? family as defined here? Have your ever worked here? If yes, When? How did you hear about this position? Employee Friend Relative Unemployment Other (Please state)

3 EMPLOYMENT HISTORY List your employment experiences for the past ten (10) years starting with the most recent. ACCOUNT FOR ALL PERIODS OF EMPLOYMENT AND UNEMPLOYMENT. Include any significant volunteer experience, military service and education. Complete this section even if you attach a resume. 1 In order to verify employment experience, may we contact your current employer? IF YOU HAVE HAD MORE THAN FOUR (4) EMPLOYERS IN THE LAST TEN (10) YEARS, PLEASE REQUEST AN ADDITIONAL PAGE. If any periods of time are not covered by the information above, please provide dates and details: Have you ever been involuntarily separated (fired)? If yes, please provide details:

4 SKILLS/KNOWLEDGE/EDUCATION PLEASE COMPLETE SECTIONS WHICH APPLY TO THE POSITION(S) YOU DESIRE CLERICAL POSITIONS ONLY Indicate your skills, equipment knowledge or education. (CHECK AS MANY AS APPLY) Typing WPM Shorthand WPM Dictaphone Clerical Classroom Training-School (Name & Address): Dates - From: To: Certificate received? Type: Word Processor Please state brands: Other (please describe): DRIVER/MECHANIC/SERVICE WORKER POSITIONS ONLY The California Department of Motor Vehicles requires that applicants for the Class B driver s license have successfully completed the Federal Department of Transportation Medical Examination. Would you consent to this exam at CCCTA s expense? Have you ever had a job that involved driving? If yes, what type of vehicle? Has your driving license ever been revoked or suspended? If yes, please explain: Number of years of employed driving experience: Do you have valid California driving license? License Number: Expiration Number: Class C Class B Class A How many moving violations have you received in the last five years? Are there any restrictions on your driving license? If yes, please state restriction(s): How many traffic accidents have you been involved in during the last five years? MECHANIC/SERVICE WORKERS POSITON Have you ever had a job that involved mechanical repair of a diesel vehicle? Do you have your own tools? If yes, what type of vehicle(s)? If yes, which types? Have you taken mechanics vocational training? School (name & address): Name of course: Certificate received? What type? GENERAL INFORMATION Please indicate below any other information which you feel may qualify you for the type of work desired. Dates - From: To: PLEASE READ CAREFULLY BEFORE SIGNING I certify that the information given by me in this application is true and complete. I understand and agree that any false information, misrepresentation, omission, or concealment of fact is sufficient grounds for either my immediate discharge without recourse or refusal of employment by CCCTA. I fully understand that if I am not bondable by a surety company, CCCTA may be unable to offer employment. I understand and agree that all information furnished in this application may be verified by CCCTA. I hereby authorize all individuals and organizations named or referred to in this application and any law enforcement organization to give CCCTA all information relative to my employment, work habits and character and herby release such individuals, organizations and CCCTA from any liability for any claim or damage which may result. Signature: Date:

5 CENTRAL CONTRA COSTA TRANSIT AUTHORITY APPLICATION EQUAL EMPLOYMENT OPPORTUNITY SURVEY CONFIDENTIAL Please complete this survey and submit it with your application for employment. Federal and State agencies require that we collect the data which is requested below for statistical reporting purposes in connection with our affirmative action efforts. Your completed survey form will be detached from your application for employment and kept separate and confidential in the Authority s EEO Office. The information requested here will not be used in any discriminatory manner. You are not required to complete this form to be considered for employment. However, the information you provide will be most helpful and appreciated. Position: Name: Date of Birth: Male: Female: DISABILITY and MILITARY SERVICE (Please complete if applicable) Are you disabled? (A person with a disability is defined as an Individual who (1) has a physical or mental impairment that substantially limits one or more of his/her major life activities; (2) has a record of such an impairment; or (3) is regarded as having an impairment.) Are you a Veteran? If yes, indicate dates of service: From To ETHNIC BACKGROUND (Please check only one) HISPANIC or LATINO: A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin regardless of race. WHITE (n-hispanic or Latino): All persons having origins in any of the original peoples of Europe, rth Africa, or the Middle East. BLACK or AFRICAN AMERICAN (n-hispanic or Latino): A person having origins in any of the Black racial groups of Africa. ASIAN (n-hispanic or Latino): A person having origins in any of the original peoples of the Far East, Southeast Asia, the Indian Subcontinent, or the Indian Subcontinent, including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam. NATIVE HAWAIIAN OR OTHER PACIFIC ISLANDER (n-hispanic or Latino): A person having origins in any of the peoples of Hawaii, Guam, Samoa, or other Pacific Islands. AMERICAN INDIAN OR ALASKA NATIVE (n-hispanic or Latino): A person having origins in any of the original peoples of rth and South America (including Central America), and who maintain cultural identification through tribal affiliation or community attachment. TWO OR MORE RACES (n-hispanic or Latino): All persons who identify with two or more racial categories named above. DECLINE TO STATE Signature: Date: Updated 04/17 01/2016