NEW DCTB APPLICATION
DCTB EMPLOYMENT APPLICATION
Delaware County Transit Board
Employment Application
Position Desired *
Your answer
Full Name *
Your answer
Date *
MM
/
DD
/
YYYY
Name: First, MI, Last
Your answer
Street Address *
Your answer
City
Your answer
State, Zip *
Your answer
Phone
Your answer
Email Address
Your answer
WORK EXPERIENCE
Current/Most Recent Position
Your answer
Employer Address
Your answer
Supervisor Contact Information
Your answer
Dates of Employment: From: To:
Your answer
Full Time or Part Time
Hourly Wage/Annual Salary
Your answer
Reason for Leaving
Your answer
May we contact this employer?
Responsibilities/Accomplishments at this Position
Your answer
Previous Position
Your answer
Employer Address
Your answer
Supervisor Contact Information
Your answer
Dates of Employment: From: To:
Your answer
Full Time or Part Time
Hourly Wage/Annual Salary
Your answer
Reason for Leaving
Your answer
May we contact this employer?
Responsibilities/Accomplishments at this Position
Your answer
Previous Position
Your answer
Employer Address
Your answer
Supervisor Contact Information
Your answer
Dates of Employment: From: To:
Your answer
Full Time or Part Time
Hourly Wage/Annual Salary
Your answer
Reason for Leaving
Your answer
May we contact this employer?
Responsibilities/Accomplishments at this Position
Your answer
Educational Background
High School
Name of Schools
Your answer
Location
Your answer
Did you Graduate?
Do you have a GED?
Educational Background
Colleges, Universities, and Technical Schools Attended
Name
Your answer
Location
Your answer
Major Area of Study
Your answer
Degree
Your answer
Graduated?
Grade Point Average
Your answer
Name
Your answer
Location
Your answer
Major Area of Study
Your answer
Degree
Your answer
Graduated?
Grade Point Average
Your answer
Credentials
Professional License(s), Certificate(s), or Other Credentials
Description
Your answer
By Whom Issued
Your answer
Date Awarded
MM
/
DD
/
YYYY
Expiration Date
MM
/
DD
/
YYYY
Description
Your answer
By Whom Issued
Your answer
Date Awarded
MM
/
DD
/
YYYY
Expiration Date
MM
/
DD
/
YYYY
Additional Education, Training, and Computer Knowledge
Please describe any specific course work, training, or qualifications you have for this position.
Your answer
Please describe your knowledge of, and capabilities with, computer programs.
Your answer
Professional References
Please fill in three (3) professional references: (Include only professional references. Must include at least one (1) supervisor or previous supervisor.) Friends and family will not be accepted as references.
Name
Your answer
Employer
Your answer
Current Position
Your answer
Phone
Your answer
Email
Your answer
Relationship to Candidate/Years Known
Your answer
Name
Your answer
Employer
Your answer
Current Position
Your answer
Phone
Your answer
Email
Your answer
Relationship to Candidate/Years Known
Your answer
Name
Your answer
Employer
Your answer
Current Position
Your answer
Phone
Your answer
Email
Your answer
Relationship to Candidate/Years Known
Your answer
Additional Information
Do you have an Ohio Driver's License?
Do you have a Commercial Driver's License (CDL)?
If so, does it include Passenger Endorsement?
Equal Opportunity Employer
Delaware County Transit Board (DCTB) is an Equal Opportunity Employer. DCTB ensures equal employment opportunities regardless of race, color, national origin, religion, age, sex, disability, military status, genetic testing or other unlawful bias except when such a factor constitutes a bona fide occupational qualification (BFOQ). All personnel decisions and practices including, but not limited to, hiring, suspensions, terminations, layoffs, demotions, promotions, transfers, and evaluations, shall be made without regard to the above listed categories. DCTB intends for all of its policies to comply with federal and state equal employment opportunity principles and other related laws.
DCTB condemns and will not tolerate any conduct that intimidates, harasses, or otherwise discriminates against any employee or applicant for employment on the grounds listed above. Anyone who feels that their rights have been violated under this policy should submit a written complaint of discrimination to the department supervisor, Executive Director, or Human Resources within 90 days of the date of application.
Any individual needing assistance in making application for any opening should contact the Human Resources department.
APPLICANT'S ACKNOWLEDGMENT AND AGREEMENT
By typing my name below, I give my permission to DCTB, its members, its officeholders, and its employees and agents to contact my references and perform a background check to learn about my employment and criminal history.
I, the undersigned applicant for employment with DCTB for consideration as a candidate for a job for which I am qualified, forever release and waive any and all claims I may have against DCTB for inquires made of my prior or current employers.
I also forever release and waive any claims against any and all of my prior or current employers for their disclosure of information to DCTB. I have reviewed and read this Release and Waiver Form and have had an opportunity to review it if I choose to, with my own attorney before signing it. If I choose not to review with my attorney, I sign this Release and Waiver Form of my own free will.
TYPE NAME HERE
Your answer
DCTB DOT PHYSICAL AND DRUG TEST RELEASE CONSENT FORM
I hereby authorize DCTB to conduct a DOT Physical and drug and alcohol tests for the position for which I am applying or currently hold. I further authorize DCTB to receive the physical and drug and alcohol test results. I hereby waive any privileges and release DCTB and all referring entities from any liability involved in producing this information. I understand that any employment with DCTB, will be contingent upon the result of the drug and alcohol tests that I have so authorized. I understand if I am applying for a driving position, I must receive DOT medical certification of at least one year to be eligible for hire. I understand that failing the physical or drug or alcohol test is cause for the refusal of employment or for termination after employment.
DCTB BACKGROUND CHECK CONSENT FORM
I hereby authorize DCTB to conduct a job-related background check and obtain a background check for the position for which I am applying or currently hold. I authorize DCTB to obtain any information that may be sought concerning me and my work, my habits, character and skill, driving record, and I hereby waive any privileges and release DCTB and all referring entities from any liability involved in producing this information.
I further authorize DCTB to make any lawful examination of my criminal conviction record, and I release any police or law enforcement agency, and all individuals connected therewith, from all liability in providing such information. I understand that any employment with DCTB will be contingent upon the result of any background check that I have so authorized. I understand that false or inaccurate statements on my employment application will be cause for the refusal of employment or for termination after employment.
By typing my name below, I certify the above statements to be true and correct, to the best of my knowledge, and that this information can be used for the purpose of processing my employment application and information. I understand that this application for employment does not create a contract of employment.
I further understand that this application for employment is a public record, and therefore, is subject to open records requests. I am aware that my application will be retained and is active only until the position for which I am applying is filled. After that time, I will need to submit another application if I would like to apply for another position in the future.
I agree to all of the terms above.
TYPE NAME HERE
Your answer
Submit
Never submit passwords through Google Forms.
This form was created inside of Delaware Area Transit Agency.