Employment Application

Career Application 2023

Name(Required)

First Middle Last

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone

Date Available

Desired Salary

Position Applying For

DL #

State

Class

Exp. Date

Endorsements(Required)

Are you a citizen of the US

If no are you authorized to work in the US

Have you ever worked for this company

If you have worked for Coast RTA explain

When

Have you ever been convicted of a felony

If yes explain

Education

High School

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Date

Years attended

College

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Year Started

Year Finished

Other

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Year Started

Year Finished

References

Please List Three Professional References

Name 1

First Last

Relationship

Company

Phone

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Name 2

First Last

Relationship

Company

Phone

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Name 3

First Last

Relationship

Company

Phone

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Previous Employment

Beginning with the most recent

Company 1

Phone

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Supervisor

First Last

Job Title

Starting Salary

Ending Salary

Responsibilities

From

Reason for leaving

Company 2

Phone

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Supervisor Name

First Last

Job Title

Starting Salary

Ending Salary

Company 3

Number

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Supervisor

First Last

Job Title

Starting Salary

Ending Salary

Responsibilities

From

Reason For Leaving

May We Contact Previous Employer for Leaving

Military Service

Branch

Rank at Discharge

If other than honorable, Explain

Drug and Alcohol Testing

Have you ever been denied a position on the basis of a positive alcohol or drug test.

Do you have relatives working for the Authority?

If the answer to this question is “yes” please list below

Voluntary Affirmative Action Record

Date

Position Applied For:

Name

Phone

Address

City

State

Zip

Sex

Ethnicity

Referral Source

Career Application 2023

Education

References

Previous Employment

Military Service

Drug and Alcohol Testing

Voluntary Affirmative Action Record

Our Mission

Info

Contact

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