Careers - Dependacare Transportation

If you are interested in joining the Dependacare Transportation team, please complete the form below. All applicants will be required to provide a five year motor vehicle record, pass a seven year national background check and drug test. CPR/First Aid certification will be provided once application is processed and approved. Questions marked with an asterisk are required. Thank you for your interest!

BASIC INFORMATION

Name*

First Last

Email*

Phone*

Address*

Street Address Address Line 2 City ZIP Code

Position Applying For*

Desired Weekly Salary*

Date Available to Start*

What days are you available?*

Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday

(Please check all that apply)

How many hours do you want to work?*

Full-time
Part-time

(Please check all that apply)

Have you had any accidents in the past three years?*

Yes
No

If yes, please explain:

Have you had any moving violations in the past three years?*

Yes
No

If yes, please explain:

Have you ever been convicted of, or entered a plea of guilty, no contest, or had a withheld judgement to a felony?*

Yes
No

If yes, please explain:

I certify that I am a U.S. Citizen, permanent resident, or a foreign national with authorization to work in the United States.*

Yes
No

EDUCATION

College or University

From

MM

DD

YYYY

To

MM

DD

YYYY

Did you graduate?

Yes
No

Degree

High School*

Did you graduate?*

Yes
No

EMPLOYMENT HISTORY

Please list your last three jobs starting with the most recent.

Company*

Job Title*

City, State*

City State

From*

MM

DD

YYYY

To*

MM

DD

YYYY

List your primary skills & responsibilities:*

Ending salary/hourly rate?*

Reason for leaving?*

Supervisor Name & Title*

May we contact your supervisor for a reference?*

Yes
No

Company

Job Title

City, State

City State

From

MM

DD

YYYY

To

MM

DD

YYYY

List your primary skills & responsibilities:

Ending salary/hourly rate?

Reason for leaving?

Supervisor Name & Title

May we contact your supervisor for a reference?

Yes
No

Company

Job Title

City, State

City State

From

MM

DD

YYYY

To

MM

DD

YYYY

List your primary skills & responsibilities:

Ending salary/hourly rate?

Reason for leaving?

Supervisor Name & Title

May we contact your supervisor for a reference?

Yes
No

REFERENCES

Please provide two references.

Name*

First Last

Relationship to you*

Phone*

Years Known*

Name*

First Last

Relationship to you*

Phone*

Years Known*

If you have a resume and would like to submit it, please upload it below.

I certify that my answers are true and complete to the best of my knowledge. I understand that any misleading or incorrect statements made on this application or omissions of facts will be considered sufficient cause for denial or termination of employment without any liability to the Company. I authorize Dependacare Transportation to conduct such investigation as may be necessary to verify the information contained in this application and to determine my qualifications for the position for which I am being considered. I authorize the companies, schools, or persons named on this application to give the Company any information regarding my employment, character, and qualifications, together with any information that they may have regarding me whether or not it is in their records. I further understand that an investigative consumer report, including information as to my character, general reputation, personal characteristics, and mode of living, whichever is applicable, may be made, and upon written request by me, within a reasonable period of time, I shall receive a complete and accurate disclosure of the nature and scope of the investigation. I understand that all offers of employment are conditional, subject to the receipt of satisfactory reference and background investigations. If employed, I agree to comply and abide by the rules and regulations of the Company. I recognize my employment will be subject to the conditions of my applicable introductory period or Company policy. I understand that, if employed, my employment relationship with the Company is an at-will relationship, and as such may be terminated at any time by either party. Nothing in the application form, employee handbooks, or policy manuals is intended by the Company to be an express or implied contract of employment or guarantee of employment for a specific period of time between the company and/or me, unless clearly stated and signed by both parties. If employed, I agree to cooperate with any security-related investigations or inquiries deemed necessary by the Company at any time. Except to the extent authorized by the company, I will preserve in strictest confidence any information I have or may acquire regarding any of the Company’s confidential business affairs.

I agree to the above disclaimer.*

Yes
No

Comments

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