Employment Application

Full Name

Street Address

City

State

Zip Code

Phone

Email Address

Currently Employed Currently Employed Yes No

May we contact your Employer? May we contact your Employer? Yes No

What date are you available for work?

Are you available to work? Are you available to work? Full Time Part Time Temporary

Are you on a lay-off and subject to recall? Are you on a lay-off and subject to recall? Yes No

Have you ever been convicted of any crime at any time? Have you ever been convicted of any crime at any time? Yes No

If yes, please explain

Are you willing to transport children as part of the job? Are you willing to transport children as part of the job? Yes (If yes, refer to Section B) No

SECTION B CLASSIFICATION SECTION B CLASSIFICATION BUS DRIVER

Classification:

Bus Driver:

New Jersey Driver’s License Number:

Do you also possess a CDL license? Do you also possess a CDL license? Yes No

If yes, please state the Class

Do you have experience transporting school and/or camp children? Do you have experience transporting school and/or camp children? Yes No

Have you ever been convicted of DWI or had your driver’s license revoked for any reason? Have you ever been convicted of DWI or had your driver’s license revoked for any reason? Yes No

If yes, please explain

If you have been a school bus driver, please summarize your work experience.

Name of Reference #1

Phone for_Reference_#1

Address for_Reference_#1

Name of Reference #2

Phone for_Reference_#2

Address for_Reference_#2

Name of Reference #3

Phone for_Reference_#3

Address for_Reference_#3

By checking this box I consent to having a background check By checking this box I consent to having a background check Yes I do