Public Transportation for Mitchell, Jewell, Osborne in Kansas

Today's Date

Name:

Phone:

Current Address (include City, State, Zip)

Email:

Position Applying For:

Have you worked for a transportation system before?

Yes

No

Agency Name:

Dates

How did you hear about this position?

Current Employee

Facebook

Radio

Other

Are you related to anyone in our system? Who and How?

Have you been convicted of a felony?

Yes

No

If Yes, Dates & Explanation:

Education: List Names/Locations of Schools/Colleges. Did you graduate? Date of Graduation. Degrees Received.

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Attach Resume

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Attach References

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This certifies that this application was completed by me, and that all entries on it are true and complete to the best of my knowledge. I authorize you to make such investigations and inquiries of my personal, employment, financial or medical history and other related matters as may be necessary in arriving at an employment decision. (Generally, inquiries regarding medical history will be made only if and after a conditional offer of employment has been extended.) I hereby release employers, health care providers and other persons from all liability in responding to inquiries and releasing information given in my application or interview(s) may result in discharge. I understand, also that I am required to abide by all rules and regulations of the company.

Yes

Trip Coordinator Application