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Harbor Transit Application for Employment

Harbor Transit Application for Employment

Harbor Transit does not discriminate on the basis of religion, race, sex, color, national origin, age, height, weight, familial status, marital status, disability, genetic information, sexual orientation, gender identity, or any other characteristic protected by law in employment or the provision of services.
Although this application may be given consideration, its receipt does not imply that there are open positions or that the applicant will be employed. Harbor Transit reserves its right to withdraw any offer of employment at any time. Similarly, the applicant has the right to withdraw this application at any time. If you wish to submit a resume, you may attach it to this application. In addition, you must complete this application and answer all questions, even those which relate to information on your resume. Please be sure that all of your answers on this application are complete, correct, and truthful. You should understand that any omission of relevant information, any false or misleading statement, or any failure to disclose facts which if known might reflect unfavorably on this application, may result in dismissal even after you are employed.

Maximum file size: 52.43MB

Section 1: Personal Information

Name
Name
Last
First
Street Address
Street Address
City
State/Province
Zip/Postal
Are you 18 years or older?
Are you eligible to work in the U.S.?
Have you ever plead “no contest” to or been convicted of theft, shoplifting, robbery, embezzlement, forgery, perjury, tax evasion, or any other crime involving dishonesty?
Are you currently under indictment, arraignment, or charged with a felony?

Section 2: Employment Desired

Type of work sought:

Section 3: Education - Please complete, even if attaching a resume.

Did you graduate?
Did you graduate?
Did you graduate?

Section 4: Driving History

Do you currently hold a Michigan Drivers' License?
Do you currently hold a Commercial Drivers' License?
Does your driving record contain any of the following: more than 2 points, more than 2 moving violations in the past 3 years, more than 1 at-fault accident, speeding 15 mph over limit or more, reckless/careless driving, open intoxicants, and/or a drug crime?
Have you ever tested positive for drugs or alcohol on a DOT required test?
Do you have reliable transportation to get to work?

Section 5: Employment and Experience - Please complete, even if attaching a resume.

Former Employers (List below last four employers, starting with most recent):
Present membership in National Guard or Reserves?
Employer 1 Address:
Employer 1 Address:
City
State/Province
Zip/Postal
Country
Are you presently employed?
If yes, may we contact?
Employer 2 Address:
Employer 2 Address:
City
State/Province
Zip/Postal
Country
Are you presently employed?
If yes, may we contact?
Employer 3 Address:
Employer 3 Address:
City
State/Province
Zip/Postal
Country
Are you presently employed?
If yes, may we contact?
Employer 4 Address:
Employer 4 Address:
City
State/Province
Zip/Postal
Country
Are you presently employed?
If yes, may we contact?
Have you ever been fired, dismissed, asked to resign, resigned by mutual agreement, or otherwise been terminated from any job?
May Harbor Transit contact these employers?

Section 6: References

Give names of three work related references, not related to you, whom you have known at least one (1) year. Please complete all information.

Section 7: Voluntary Disclosure Form

Harbor Transit provides equal employment opportunities to all employees and applicants for employment without regard to race, color, religion, national origin, sex (including gender identity, sexual orientation, and pregnancy), age, genetic information, disability, veteran status, or other protected class. This applies to all personnel actions, including but not limited to recruitment, hiring, selection for training, promotion, transfer, demotion, layoff, termination, rates of pay, or other forms of compensation. Completion of this form is entirely voluntary and will not affect your employment status, application, or opportunities with Harbor Transit. The information will be kept confidential and used only in accordance with the provisions of applicable federal laws, executive orders, and regulations, including those requiring information to be summarized and reported to the federal government for civil rights purposes. All race/ethnicity information is collected and reported in six EEO-4 categories established by the federal government: (A) Asian; (B) Black or African American; (H) Hispanic or Latino; (I) American Indian or Alaska Native; (P) Native Hawaiian or Other Pacific Islander; or (W) White. If you choose not to disclose your race/ethnicity, the federal government requires the employer to determine this information by visual survey and/or other available information. Please mark one box describing the gender identity, race/ethnicity, and veteran status with which you identify.
1. Gender Identity: Please select the gender you identify with most.
2. Race/Ethnicity: Please check all that apply.
3. Veteran Status: Are you a United States military veteran?
Personal Information (Used only for data tracking purposes.) NAME: (optional)
Personal Information (Used only for data tracking purposes.) NAME: (optional)
First Name
Last Name

Section 8: Voluntary Self-Identification of a Disability

Form CC-305 OMB Control Number 1250-0005 WHY ARE YOU BEING ASKED TO COMPLETE THIS FORM? Federal law requires us to provide equal employment opportunity to qualified people with disabilities. To do this, we must ask applicants and employees if they have a disability or have ever had one. People can become disabled, so we need to ask this question at least every five years. Completing this form is voluntary, and we hope that you will choose to do so. Your answer is confidential. No one who makes hiring decisions will see it. Your decision to complete the form and your answer will not harm you in any way. If you want to learn more about the law or this form, visit the U.S. Department of Labor’s Office of Federal Contract Compliance Programs (OFCCP) website at www.dol.gov/ofccp.
Disabilities include, but are not limited to:
A disability is a condition that substantially limits one or more of your “major life activities.” If you have or have ever had such a condition, you are a person with a disability.

Reasonable Accommodation Notice

Federal law requires employers to provide reasonable accommodation to qualified individuals with disabilities. Please tell us if you require a reasonable accommodation to apply for a job or to perform your job. Examples of reasonable accommodation include making a change to the application process or work procedures, providing documents in an alternate format, using a sign language interpreter, or using specialized equipment. To request a reasonable accommodation, please contact the Human Resources Director at (616) 842-3220, ext. 4, or hr@harbortransit.org
Disability Status
Personal Information (Used only for data tracking purposes.) NAME: (optional)
Personal Information (Used only for data tracking purposes.) NAME: (optional)
First Name
Last Name

Section 9: Authorization and Waiver

As part of my employment application filed with Harbor Transit, I have listed my former and/or current employers, as well as additional references. I authorize each former or current employer and each additional reference to communicate directly with Harbor Transit relative to my employment record and any other relevant information which would or could have a bearing on my ability or inability to adequately perform for Harbor Transit the job for which I have applied. I specifically waive any right I have under Section 6 of Michigan Public Act 397 of 1978, as now or subsequently amended (the “Bullard-Plawecki Employee Right to Know Act), to receive written notice if a current or former employer divulges a disciplinary report, letter of reprimand, or other disciplinary action to Harbor Transit. I release all former employers, education institutions, law enforcement agencies, and credit reporting services from, and I waive any liability or claim relating to the release of information or opinions, and any employment decisions made by Harbor Transit as a result thereof. I understand and agree that Harbor Transit may conduct a criminal conviction record check (including but not limited to a driving conviction record check) in connection with my application for employment. By signing below I hereby consent to such record checks and authorize the release of such records. I certify that all the information submitted by me on this application is true and complete and I understand that if any false information, omissions, or misrepresentations are discovered, my application may also be rejected and, if I am employed, my employment may be terminated. In consideration of my employment, I agree to conform to Harbor Transit’s policies and procedures. I certify that I have read and understand the provisions of this application. My questions concerning the application, if any, have been asked and answered to my satisfaction. For purposes of this authorization and waiver, a photocopy of my signature shall have the same force and effect as my original signature.

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Grand Haven, MI 49417-1124

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