TARTA Employment Application

Personal Data

Date of Application*

Name*

First Last

First

Address*

Street Address City State ZIP Code

Date of Birth*

Please enter your date of birth

Phone Number*

Best number to reach you at

Email*

Best email to reach you at

Have you ever been employed with TARTA?*

Yes

Please check one

If yes, when did you work for TARTA?

Are you interested in:*

Full-time

Part-time

Temporary Work

Split Shifts

Check check all that apply.

Are you available to work any day of the week, including weekends and holidays?*

Yes

Please check one

Were you referred by a TARTA employee?*

Yes

If referred, please lprovide Employee's full name

Are you legally authorized to work in the United States?*

Yes

Please check one

Driving and Performance

This section is for individuals who are applying for a position which requires driving of TARTA owned vehicles or personally owned vehicles.

Do you carry a commercial Driver's License?*

Yes

Please check one

Do you have a valid Driver's License?*

Yes

Please check one

Driver's License Number*

Please list the Driver's License Number.

Driver's License State of Issue*

Please list the state your Driver's License was issued. If no valid license, please list NA.

Date License Expiration Date*

Please list when your Driver's License expires.

Have you ever had any moving violations?*

Yes

Please check one

If you have had moving violations, please list how many.

Number of moving violations

Has your Driver's License any state, including Ohio, ever been suspended or revoked?*

Yes

Please check one

If yes, please provide State, reason and year(s).

Haven you ever been in any traffic accidents since acquiring a driver's license?*

Yes

Please check one

If yes, please describe, including month/year.

Have you been disciplined or dischared for any of the following?*

Failure to Notify when absent or tardy?

Fighting or assault related offences?

Violations of safety rules?

Accidents?

Other?

None of the above

Please check one

If other, please describe

Describe discipline if other.

Medical Requirements

As a condition of employment, do you consent to taking a post-offer/pre-employment physical?*

I understand my emplyment is subject to satisfactorily passinga drug screen*

Another post-offer/ pre-employment requirement is a successful completion of employment and background checks. Do you agree to undergo these checks?*

Have you ever tested positive or refused any alcohol or drug for a safety or non safety-sensitive position for which you were not hired?*

I understand all TARTA employees are subject to further employment related screens?*

Education

All credentials must be verified.

Name of High School*

Location of High School*

High School Diploma?*

Yes

GED?*

Yes

Name of College/University

Location College/University

College Graduate?

Yes

Degree Earned

Major

Are you planning further education, training, study, or certification?*

Yes

Please choose one

If yes, please explain.

Have you ever served in the Armed Services of the United States?*

Yes

Please choose one

If yes, please list branch and years

List any additional infonnation or special qualifications you have for the requested position(s):

Employment History - start with most recent job

Company*

Name of the Company you worked for

Dates Employed*

Please list the dates you were employed

Supervisor*

Your direct supervisor

Company Phone*

Company phone number

Company Address*

Street Address City State ZIP Code

Please list your reason for leaving. NA if still employed.

Reason for leaving*

Responsibilities

Previous Addresses

If previous address was in a different County, City or State that is different from your current address.

Address

Street Address City State / Province / Region

Disclaimers

Do you fully understand that the first ninety (90) days of your employment, beginning with your in-service date, will be probationary, which means that your continued employment will be at the discretion of TARTA?*

Yes

Do you authorize TARTA to make any investigation/background checks TARTA considers necessary regarding your employment?*

Yes

INSURABILITY: All TARTA safety-sensitive employees must maintain proper credentials at a level that qualifies for insurability under TARTA's insurance requirements at standard rates. Whenever, during the time of employment, an employee's record exceeds that point level threshold for insurability, I understand and agree I will be immediate! terminated.*

Yes

Thank you for considering TARTA in your job search. Please review your application for completeness and accuracy. Make sure that all questions have been answered. TARTA will not accept an application for processing ifit is incomplete, illegible, and/or if the applicant does not meet the minimum qualifications. The time limitation for filing claims against TARTA is six (6) months from the date of application submission. Please place complaint in writing and mail (certified mail preferred) to TARTA's EEO Officer or Chief Executive Officer at P.O. Box 792, Toledo, OH 43697-0792. Applications are valid for six (6) months from the date of submission; if you wish to be reconsidered for employment after the six (6) months, you must re-apply. Per the Ohio Revised Code Statutory Definition (ORC 149.01 l(G), this application is considered a public record and as such is ovemed by the Ohio Sunshine Laws.

I have read and understood the above statement.*

Yes

DISCLOSURE REGARDING BACKGROUND INVESTIGATION ON YOU TARTA ("the Company") may obtain "consumer reports" about you from a consumer reporting agency for employment purposes. A consumer report" is a background screening report that may contain information regarding your criminal history, sex offender registry status, credit history, employment history, education history, social media activity, workers comp history, driving history, professional licenses, and other information about you. It may bear upon your character, general reputation, personal characteristics, and/or mode of living.

I have read and understood the background investigation disclosure.*

Yes

Acknowledgement & Signature

I certify that the statements made in this application and hiring process and all supporting documents are true and correct to the best of my knowledge. I understand and agree that any falsification, misstatement, or omission of fact, or illegal or illicit behavior statements made at any time, or failure to timely provide verification of information submitted on this application will result in disqualification of my application or termination of my employment whenever discovered.*

Your name

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Comments

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Employment Application

Personal Data

Driving and Performance

Medical Requirements

Education

Employment History - start with most recent job

Previous Addresses

Disclaimers

Acknowledgement & Signature

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