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671 A/B City Bus
674 A/B/C/D/E Storrs-Willimantic
993 Willimantic-Danielson
991 Willimantic-Norwich (Route 32)
675/676 Hunting Lodge/Depot
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Work at WRTD
Kindly fill the below form to submit your application to WRTD:
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Name
*
First
Last
Date of Birth
*
Present Address
*
Telephone Number and Area Code
*
Email Address
*
If hired, can you present evidence of your legal right to work in the US?
Yes
No
List any other names that you have used in the past 10 years
List all addresses for the past 10 years
Have you ever been fired or asked to resign by an employer?
*
Yes
No
If yes, explain:
What position are you applying for?
*
Minimum salary / wage requirement:
Social Security Number
*
How were you referred to our company?
*
Banner
Flyer
Print Ad
On-line Ad
Radio/TV Ad
State Employment Agency
Job Fair
Community Organization
Employee Referral-Name
Other
If employee referral/other, please specify:
Have you ever worked for our company?
*
Yes
No
In what position?
When?
If hired, what date are you available to start work?
*
Are you applying for:
*
Full-time
Part-time
Are you able to work:
*
Days
Evenings
Weekends
Name and location of Elementary and Junior High/Middle School
*
Highest grade completed in Elementary and Junior High/Middle School
*
Name and location of High School and/or G.E.D.
*
Highest grade completed in High School and/or G.E.D.
*
Name and location of College
*
Degree/Certificate earned
*
Did you graduate?
*
Yes
No
Degree
*
Major
*
Name and location of Trade, Business, Correspondence or Graduate School
Degree/Certificate earned
Did you graduate?
Yes
No
Degree
Major
List any other training or educational programs of note
List any academic honors or other special recognition you have received
List any extracurricular activities and school offices of note:
Previous Employer 1 name
Dates employed (mo/yr)
Beginning salary/pay rate
Ending salary/pay rate
Employer Address
Employer Phone
Supervisor's name & title
Position(s) held
Briefly explain your job duties & responsibilities including supervisory experience
May we contact the employer?
Yes
No
Was this position covered under the Federal Motor Carrier Safety Regulations (FMCSR)?
Yes
No
Previous Employer 2 name
Dates employed (mo/yr)
Beginning salary/pay rate
Ending salary/pay rate
Employer Address
Employer Phone
Supervisor's name & title
Position(s) held
Briefly explain your job duties & responsibilities including supervisory experience
May we contact the employer?
Yes
No
Was this position covered under the Federal Motor Carrier Safety Regulations (FMCSR)?
Yes
No
Previous Employer 3 name
Dates employed (mo/yr)
Beginning salary/pay rate
Ending salary/pay rate
Employer Address
Employer Phone
Supervisor's name & title
Position(s) held
Briefly explain your job duties & responsibilities including supervisory experience
May we contact the employer?
Yes
No
Was this position covered under the Federal Motor Carrier Safety Regulations (FMCSR)?
Yes
No
Identify and explain any employment gaps, or periods of unemployment of 30 days or longer
*
I hereby certify that all of the information provided by me in this application (or any other accompanying or required documents) is correct, accurate and complete to the best of my knowledge.
*
Choice 1
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