Employment Application Form

The information requested below MUST be provided for all positions which require your ability to drive a company-owned vehicle.

Please document all employment for the previous ten years, including jobs held while in school or in the military. Record your current or last position and list backwards in chronological order. Be sure to complete all questions for each job. Please explain any gap or periods of unemployment lasting more than 30 days.

Briefly summarize any additional qualifications you believe are important in considering your Application of Employment.

I certify that all statements made on the Application for Employment, and in any subsequently executed medical questionnaire or any other employment documents, are true and correct. I understand that any false information I give, or omission of information, may result in termination of my candidacy or subsequent employment.

If an employee relationship is established, I understand that such employment is terminable at will, by either me or Cache Valley Transit District (CVTD) at any time, for any reason, with or without cause, and with or without notice. I also understand that any period of employment is not for a specific duration. In addition, I understand that no one is authorized to make oral exceptions to this policy, and that written exceptions are permitted only when they are signed by the General Manager of CVTD. In compliance with federal law, all persons hired will be required to verify identity and eligibility to work in the United States and to complete the required employment eligibility verification form upon hire.

I authorize CVTD and its representatives to contact all former employers or others who know me or know of me. It is agreed and understood that CVTD and its agents may conduct background evaluations including, but not limited to, criminal history checks from Federal, State or local authorities to ascertain any and all information of concern, where same is of record or not, and I hereby expressly authorize such inquiries and release all employers and persons named herein from all liability for any damages on account of their furnishing such information.

It is agreed and understood that CVTD and its agents may obtain information including, but not limited to, Department of Transportation mandated Pre-employment information, refusals to test, alcohol tests of >.04, other violations of the DOT alcohol and drug rules, and return to duty and follow-up testing compliance, as applicable, and I hereby expressly authorize such inquiries and release all employers and persons named herein from all liability for any damages on account of their furnishing such information. I acknowledge that any offer of employment is conditioned upon taking a drug screen and CVTD’s receipt of satisfactory results of such a test and, if necessary to determine ability to perform essential duties of the position offered, the results of a physical examination.

By signing below, I certify that this application was completed by me and that all entries on it, and information in it, are true and complete to the best of my knowledge. I also certify that I have read, understand, and agree to the above.