Start with your present or last job. Include any military service assignments and volunteer activities. You may exclude organization names which indicate race, color, religion, sex, national origin, disability, age, ancestry, martial, veteran, or other protected status. This must be completed even if you have attached a resume.

Please provide references not related to you.

Please read carefully before signing. If you have any questions regarding the following statements, please ask for assistance. I certify that, to the best of my knowledge and belief, the answers given by me to the foregoing questions and the statements made by me in this application are correct and complete. I understand that any false information contained in this application may result in my discharge, if I am employed. I authorize you to communicate with all my former employers, school officials and persons named as references. I hereby release all employers, schools and individuals listed in this application from any liability for any damage whatsoever resulting from giving such information. I understand that as this organization deems necessary, I may be required to work overtime hours or hours outside of normally defined work day or work week. If employed, I understand and agree that such employment may be terminated at any time, without cause and without any liability to me for any continuation of salary, wages, or employment related benefits.

NOTE: This application is only valid for the position listed. Enclosures for DOT Positions: • MVR Authorization • Confidential Past Employer Inquiry • Previous Pre-Employment Employee Alcohol and Drug Test Statement