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Driver

Pro Jupiter

This is a Contract position in Lehi, UT posted May 1, 2021.

Hill Country Transit District

4515 W. U.S. Hwy. 190

Belton, TX 76513

(254) 933-3700

Thank you for applying with Hill Country Transit District (HCTD).

This application is used as a screening tool to select the most qualified job applicants that meet the requirements of HCTD and our funding sources. Completeness, neatness, and the ability to follow the written instructions on this application form are considered in the screening process. HCTD accepts rsums only when accompanied by an HCTD application. Positions are subject to close without notice. Due to the large number of applications we receive, we will only contact applicants who are selected for an interview.

All offers of employment will be contingent on passing a criminal background investigation.

If you are applying for a driver position, you must have a valid Texas driver license. All offers of employment will be contingent upon the candidate successfully passing a Department of Transportation (DOT) physical and pre-employment drug and alcohol screening. The physical exam will be scheduled prior to the first day of employment, and is paid by HCTD.

Hill Country Transit District is an equal opportunity employer and does not discriminate against any person based on race, sex, religion, color, national origin, age, disability, marital status, or sexual orientation.

Hill Country Transit District will make reasonable accommodations for applicants with disabilities. Applicants should contact the Human Resources Department for assistance.

EEO Information Form’Employment Application Supplement

The information on this sheet regarding race and sex is needed for statistical purposes to meet federal reporting requirements on equal employment opportunity. This information is needed to analyze and assure compliance with city, state and federal Equal Employment Opportunity Laws. Your participation in this survey is voluntary and your replies will be kept confidential. This survey will be detached from your application form prior to review of qualifications and will be available only to authorized personnel for research and evaluation purposes.

Position Applying For:

Gender:

  • Male
  • Female

ETHNIC BACKGROUND

Please review all categories listed below. Determine the category which you believe best represents your ethnic background. Check one category only.

___ Hispanic or Latino: A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin regardless of race.

___ White (Not Hispanic or Latino): A person having origins in any of the original peoples of Europe, the Middle East or North Africa.

___ Black or African American (Not Hispanic or Latino)

___ Native Hawaiian or Other Pacific Islander (Not Hispanic or Latino): A person having origins in any of the peoples of Hawaii, Guam, Samoa or other Pacific Islands.

___ Asian (Not Hispanic or Latino): A person having origins in any of the original peoples of the Far East, Southeast Asia or the Indian Subcontinent, including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand and Vietnam.

___ American Indian or Alaska Native (Not Hispanic or Latino): A person having origins in any of the original peoples of North and South America (including Central America) and who maintains tribal affiliation or community attachment.

___ Two or more races (Not Hispanic or Latino)

APPLICATION FOR EMPLOYMENT

Please use

BLUE INK

To complete this application

HILL COUNTRY TRANSIT DISTRICT

An equal opportunity employer

4515 W. U.S. HWY. 190; BELTON, TX 76513

HCTD does not discriminate on the basis of race, color, creed, religion, sex, sexual orientation, age, national origin, disability, handicap, veteran’s status, or political belief. It is our intention that all qualified applicants are given equal opportunity and that selection decisions be based on job related factors.

Each question should be fully and accurately answered. No action can be taken on this application until all questions have been answered. Use

blank paper if you do not have enough room on this application. In reading and answering the following questions, be aware that none of the questions are intended to imply illegal preferences or discrimination based upon non-job-related information.

LAST NAME FIRST NAME MIDDLE NAME

MAILING ADDRESS CITY STATE ZIP

HOME PHONE OTHER MESSAGE PHONE JOB REFERENCE NUMBER

POSITION APPLYING FOR: LOCATION:

DATE AVAILABLE TO BEGIN WORK CAN YOU TRAVEL IF THE JOB REQUIRES? YES NO

IF HIRED, CAN YOU FURNISH PROOF THAT YOU ARE ELIGIBLE TO WORK IN THE U.S.? YES NO

HAVE YOU EVER BEEN CONVICTED OF A FELONY/MISDEMEANOR? YES NO (If your answer is “yes”, explain in concise detail on a separate sheet of paper, giving the dates and nature of the offense, the name and location of the court, and the disposition of the case. A conviction may not disqualify you, but a false statement will.)

HAVE YOU EVER BEEN DENIED A LICENSE, PERMIT, HAS ANY LICENSE, PERMIT, OR PRIVILEGE

OR PRIVILEGE TO OPERATE A MOTOR VEHICLE? YES NO EVER BEEN REVOKED? YES NO

(An affirmative answer will not automatically disqualify you from being considered as a candidate for employment. The date of the event, nature and seriousness of the violation and the rehabilitation will be taken into account. A record check will be conducted on all applicants hired.)

EDUCATION

HIGH SCHOOL GRADUATE? YES NO NAME OF HIGH SCHOOL:

COLLEGE(S) ATTENDED DEGREE/DIPLOMA MAJOR/MINOR OBTAINED

OBTAINED?

YES NO

YES NO

YES NO

LANGUAGES READ WRITE SPEAK FLUENCY

ENGLISH

SPANISH

OTHER:

WHAT SKILLS OR ADDITIONAL TRAINING DO YOU HAVE THAT ARE RELATED TO THE JOB FOR WHICH YOU ARE APPLYING?

DESCRIBE ANY BUSINESS EQUIPMENT WITH WHICH YOU ARE FAMILIAR (computers, photocopiers, phone, etc.)

Page 1 of 6

EMPLOYMENT HISTORY

LIST NAMES OF EMPLOYERS IN CONSECUTIVE ORDER WITH PRESENT OR LAST EMPLOYER LISTED FIRST. ACCOUNT FOR ALL PERIODS OF TIME, INCLUDING MILITARY SERVICE. PHOTOCOPY THIS PAGE AS NEEDED.

EMPLOYER: _____________________________________________________________ TELEPHONE :(_____) ___________________

MAILING ADDRESS: _____________________________________________CITY : _____________________STATE: ____________

SUPERVISOR: __________________________________________________ SALARY: _____________________________________

NATURE OF BUSINESS: _________________________________________ JOB TITLE: ___________________________________

EMPLOYMENT DATES: _____Month _____Year TO _____Month _____Year

RESPONSIBILITIES: ____________________________________________________________________________________________

______________________________________________________________________________________________________________

REASON FOR LEAVING: _______________________________________________________________________________________

EMPLOYER: TELEPHONE :(_____) _____________

MAILING ADDRESS: CITY : _________________________STATE: _________

SUPERVISOR: _______________________________________________________SALARY: ________________________________

NATURE OF BUSINESS:_______________________________________________ JOB TITLE: _______________________________

EMPLOYMENT DATES: _____Month _____Year TO _____Month _____Year

RESPONSIBILITIES: ____________________________________________________________________________________________

______________________________________________________________________________________________________________

REASON FOR LEAVING: _______________________________________________________________________________________

EMPLOYER: __________________________________________________________________ TELEPHONE :(_____) ______________

MAILING ADDRESS: _____________________________________________ CITY :_________________________ STATE: ________

SUPERVISOR: _____________________________________________________SALARY: ___________________________________

NATURE OF BUSINESS: ___________________________________________ JOB TITLE: __________________________________

EMPLOYMENT DATES: _____Month _____Year TO _____Month _____Year

RESPONSIBILITIES: ____________________________________________________________________________________________

______________________________________________________________________________________________________________

REASON FOR LEAVING: _______________________________________________________________________________________

Page 2 of 6

PERSONAL REFERENCES: (DO NOT INCLUDE RELATIVES)

NAME COMPLETE ADDRESS PHONE

HAVE YOU PREVIOUSLY BEEN EMPLOYED BY HCTD? YES NO

If yes, explain:

DOES A MEMBER OF YOUR FAMILY WORK FOR HCTD? YES NO

If yes, explain:

(Family is defined as father, mother, brother, sister, son, daughter, spouse, father/mother- in-law, brother-in-law/sister-in-law, grandfather/grandmother, grandson/granddaughter, niece, nephew, aunt, uncle, cousin, step-son/step-daughter.)

DO YOU SERVE AS A VOTING MEMBER ON HCTD’S BOARD OF DIRECTORS? YES NO

HAVE YOU SERVED ON HCTD’S BOARD WITHIN THE PAST 12 MONTHS? YES NO

DOES A MEMBER OF YOUR FAMILY SERVE ON HCTD’S BOARD? YES NO

PLEASE INCLUDE ANY OTHER INFORMATION WHICH YOU FEEL WOULD BE HELPFUL TO US IN CONSIDERING YOU FOR EMPLOYMENT, SUCH AS SKILLS GAINED WITH PREVIOUS JOBS, ARTICLES PUBLISHED, COMMUNITY ACTIVITIES OR INVOLVEMENT, OR OTHER ACCOMPLISHMENTS. YOU MAY EXCLUDE ALL INFORMATION INDICATIVE OF RACE, COLOR, RELIGION, SEX, SEXUAL ORIENTATION, AGE, NATIONAL ORIGIN, DISABILITY, VETERAN’S STATUS, POLITICAL BELIEF, OR ANY OTHER LEGALLY PROTECTED STATUS.

ARE YOU PRESENTLY EMPLOYED? YES NO

MAY WE CONTACT YOUR CURRENT EMPLOYER? YES NO N/A

MAY WE CONTACT YOUR FORMER EMPLOYERS? YES NO N/A

PLEASE READ EACH STATEMENT CAREFULLY BEFORE SIGNING

I certify that all information provided in this employment application is true and complete. I understand that any false information or omission may disqualify me from further consideration for employment and may result in my dismissal if discovered at a later date.

I authorize and agree to cooperate in a thorough investigation of all statements made herein and other matters relating to my background and qualifications. I understand that any investigation conducted may include a request for employment and educational history, credit reports, consumer reports, investigative consumer reports, driving record, and criminal history. I authorize any person, school, current and former employers, unless specified above, consumer reporting agency, and any other organization or agency to provide information relevant to such investigation and I hereby release all persons and corporations requesting or supplying information pursuant to such investigation from all liability or responsibility to me for doing so. I understand that I have the right to make a written request within a reasonable period of time for complete disclosure of the job for which I am being considered or any future job in the event that I am hired.

I understand that compliance with HCTD’s Policies is a condition of my employment.

I understand that I may be required to successfully pass a drug-screening examination, and/or physical examination. I hereby consent to a pre-and/or post-employment drug screen as a condition of my employment, if required.

I UNDERSTAND THAT THIS APPLICATION OR SUBSEQUENT EMPLOYMENT DOES NOT CREATE A CONTRACT OF EMPLOYMENT NOR GUARANTEE EMPLOYMENT FOR ANY DEFINITE PERIOD OF TIME. IF EMPLOYED, I UNDERSTAND THAT I HAVE BEEN HIRED AT THE WILL OF THE EMPLOYER AND MY EMPLOYMENT MAY BE TERMINATED AT ANY TIME, WITH OR WITHOUT CAUSE AND WITH OR WITHOUT NOTICE.

I have read, understand, and by my signature consent to these statements.

Applicant signature: Date:

Resumes accepted, but not in lieu of this application. Only applicants selected for interview will receive written notification of results.

Page 3 of 6

PLEASE PROVIDE THE FOLLOWING INFORMATION:

Do you have a commercial driver’s license (CDL)? ______Yes________No

Classification__________. Endorsements____________.

Driver License Number________________________. Issuing State_____________________.

DRIVING EXPERIENCE

Class of Equipment

Type of Equipment

(Van, Tank, Flat, etc.)

Dates of Operation

FROM TO

Total Miles of Operation

(Approximately)

Bus

Straight Truck

Tractor & Semi-Trailer

Other

ACCIDENT RECORD FOR PAST 3 YEARS

Accident

Date

Nature of Accident

(Head-on, Rear-end, etc.)

Number of

Fatalities

Number of

Injuries

Last Accident

Next Previous

Next Previous

TRAFFIC CONVICTIONS & FORFEITURES FOR THE PAST 3 YEARS

Location (City & State)

Date

Charge

Penalty

SAFE DRIVING AWARDS YOU NOW HOLD AND FROM WHOM

Page 4 of 6

HILL COUNTRY TRANSIT DISTRICT

NOTICE TO APPLICANTS

All persons who receive an offer of employment with the Hill Country Transit District must undergo pre-employment drug screening and must have a negative test result before being placed on employee status.

Have you tested positive, or refused to test, on any pre-employment drug or alcohol test administered by an employer to which you applied for but did not obtain safety-sensitive transportation work covered by Department of Transportation (DOT) agency drug and alcohol testing rules during the past two years?

Yes_____________ No______________. If your answer is yes, please explain:

___________________________________________________________________________________

___________________________________________________________________________________

Upon hiring, all employees are required to comply with the Hill Country Transit District Drug and Alcohol Policy and Testing Program.

I acknowledge receipt of this notice.

________________________________________ ________________________

Applicant Name (Printed) Social Security Number

_______________________________________ ________________________

Applicant Signature Date

Page 5 of 6

Hill Country Transit District

Residency History

Please provide a record of all addresses where you have resided for the past seven (7) years, beginning with your current address. This information will be used to obtain driving record/history and criminal background check. Photocopy this page as needed.

Applicant/Employee Name: ________________________________________________

____________________________________________________________________

Street Address

____________________________________________________________________

City State Zip Code

From:_______________________________________To:__________________________________

Dates of Residency

________________________________________________________________________

____________________________________________________________________

Street Address

____________________________________________________________________

City State Zip Code

From:_______________________________________To:__________________________________

Dates of Residency

________________________________________________________________________

____________________________________________________________________

Street Address

____________________________________________________________________

City State Zip Code

From:_______________________________________To:__________________________________

Dates of Residency

________________________________________________________________________

____________________________________________________________________

Street Address

____________________________________________________________________

City State Zip Code

From:_______________________________________To:__________________________________

Dates of Residency

I hereby certify that the above information is accurate.

____________________________________________________ ________________________

Signature Date Page 6 of 6

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