You ask ... we Deliver!

This Application Form contains pages, which you can fill out and submit by e-mail. Before completing these Application Form pages, please read these instructions:
  • This form must be completed by the applicant only.
  • Type answers clearly in each provided space.
  • Be sure to answer each question. Questions that are unanswered or that have incomplete answers may disqualify the applicant. This is particularly true of the questions about work history, driver's licenses, license suspensions, tickets and accidents.
Position applying for:

LAST NAMEFIRST NAME
MIDDLE NAMESOC. SEC. #
ADDRESS ADDRESS 2
CITYSTATE / ZIP
TELEPHONEEMAIL
DATE AVAILABLE

Only U.S. citizens or aliens who have a legal right to work in the U.S. are eligible for employment. Can you, upon employment, submit documentation verifying your legal right to work in the U.S. and your identity? YES NO

Is there anything that would prevent you from performing in a reasonable and safe manner, the activities involved in the position in which you have applied?
YES NO       If YES, please explain:

Have you ever been convicted of a felony? YES NO
If yes, give dates and explain. A conviction does not automatically mean you will not be hired. The basis for your conviction and how long ago are important. Give all of the facts so that an informed decision can be made.


EDUCATIONAL DATA
SchoolPrint Name, Number and Street, City, State and Zip Code for Each School# of Yrs CompletedDegreeMajor Course of Study
High School
College
Graduate School
Trade/Bus/Night Correspondence

Special Skills: List any job-related skills or qualifications that support your application.

Honors received:


In order to permit a check of your work and educational records, should we be aware of any change of name or assumed name that you previously used? YES NO
If yes, Identify Names and relevant dates.

Have you had prior educational experience which relates to the job for which you are applying? YES NO       If yes, please describe.

EMPLOYMENT EXPERIENCE
LIST ALL FORMER JOBS (most recent job first) Account for all time periods including unemployment, self-employment and military service.

EMPLOYER 1
EMPLOYERDATES EMPLOYED
IMMEDIATE SUPERVISORPHONE
ADDRESS
JOB TITLEHOURLY RATE/SALARY
WORK PERFORMED
REASON FOR LEAVING

EMPLOYER 2
EMPLOYERDATES EMPLOYED
IMMEDIATE SUPERVISORPHONE
ADDRESS
JOB TITLEHOURLY RATE/SALARY
WORK PERFORMED
REASON FOR LEAVING

EMPLOYER 3
EMPLOYERDATES EMPLOYED
IMMEDIATE SUPERVISORPHONE
ADDRESS
JOB TITLEHOURLY RATE/SALARY
WORK PERFORMED
REASON FOR LEAVING

EMPLOYER 4
EMPLOYERDATES EMPLOYED
IMMEDIATE SUPERVISORPHONE
ADDRESS
JOB TITLEHOURLY RATE/SALARY
WORK PERFORMED
REASON FOR LEAVING

EMPLOYMENT HISTORY
Please list reason for any lapse in employment.



Have you ever been dismissed or forced to resign from an employer? YES NO
If yes, please explain.


May we contact your present employer? YES NO

May we contact your previous employers? YES NO

Please identify any exceptions and reasons for not contacting present or prior employers.



Do you have a valid driver’s license? YES NO

State         License Number

Do you have a reliable means of transportation? YES NO

Will you work overtime if asked? YES NO

Would you work nights? YES NO

Would you work weekends? YES NO

Are there any hours, shifts or days you will not work? YES NO

If yes, explain.



Do you have any friends or relatives who work here? YES NO

If yes, please name.



Have you filed an application here before? YES NO
if yes, give date.

Have you ever been employed here before? YES NO
If yes, give dates.

REFERENCES
List three persons, not relatives or former employers, whom you have known at least one year.
NAMEADDRESS & TELEPHONEOCCUPATION

NOTICE TO APPLICANTS: This company complies with the Americans with Disabilities Act of 1990. During the interview process, you may be asked questions concerning your ability to perform job-related functions. If you are given a conditional offer of employment, you may be required to complete a post-job offer medical history questionnaire and undergo a medical examination. All entering employees in the same job category will be subject to the same medical questionnaire and examination, and all information will be kept confidential and in separate files.

APPLICANT’S STATEMENT
I certify that the answers given herein are true and complete to the best of my knowledge. I authorize the investigation of all matters contained in this application and hereby give permission to contact schools, previous employers, references, and others in order to verify the facts and information furnished with regard to my character and qualifications, and hereby release and indemnify this company from any claims or liability as a result of such contact. I also hereby release employers, schools, and other persons from all liability in responding to inquiries in connection with this application. I understand that misrepresentations, omissions of facts or incomplete information requested in this application may remove me from further consideration for employment. In addition, if employed, any misrepresentations or omissions of facts called for in this application will be cause for dismissal at any time without any previous notice.

Applicants accepted for employment should clearly understand that while we make every effort to provide steady, continuous work, we have no employment contracts, and we cannot guarantee the permanencies of any position. Job tenure can be affected by many factors including business/economic conditions, changes in laws or employee policies, conformity to our work rules, job performance, etc. and, of course, employees may elect to leave on their own accord to seek other jobs.

If I am offered and accept employment with the aforementioned company, I understand that my employment is for no specific term and may be terminated by myself or the employer with or without notice or cause at any time. I further understand that an oral promise, policy, custom, business practice or other procedure (including any employee handbook or any personnel manuals) does not constitute an employment contract or modification of the at-will employment relationship between myself and this employer.

The contents of any employee handbook or personnel manuals are subject to change or modification, without notice.

I certify that I personally completed this application and that all of the information is true and correct. I authorize Vork Motor Transport / JGS Transportation to conduct a thorough background investigation in accordance with state and federal law and authorize my previous employers to release any information requested by Vork Motor Transport / JGS Transportation and hold them harmless of all liability from the release of said information. Also, in accordance with the provisions of 49 CFR Part 382.405 and 382.413, I hereby authorize and require my previous and/or current employers specifically listed by me on this application to release the results (including any refusal to test) of all drug and alcohol tests taken by me pursuant to the provisions of 49 CFR while in their employment to Vork Motor Transport / JGS Transportation, Inc. by whatever means is most expedient.

I have read all the instructions and notices and understand them.
YES NO

Signature of Applicant

(Typing your name and submitting this form constitutes your legal signature.)

Date




VORK MOTOR & JGS | 711 Business Parkway | Carlisle, OH 45005 | Phone (937) 743-9101 | (800) 783-8675