Name & Address:
Years at Current Address
Have you resided in other counties in past 7 years?
Age & Date of Birth:
Full Time Position
Part Time Position
How Did You Find Us?
Driving Information & Experience:
EXPERIENCE & DRIVER QUALIFICATIONS ARE TYPICALLY NECESSARY IN OUR INDUSTRY - MOVING VEHICLES & OBTAINING PARTS ARE EVERY DAY OCCURENCES IN MOST POSITIONS.
Do you have current valid driver license if required for employment?
Have you held a valid driver license in any other state(s)?
Have you ever been denied a license, permit, or privilege to operate a motor vehicle?
Has any license, permit, or privilige ever been suspended or revoked?
If you have answered yes to either (or both) of the two questions listed immediately above, please use comment section below to provide details.
Tractor & Trailer
Have you had any accidents - regardless of fault, within the past 3 years?
Have you had any traffic tickets or forfeitures / suspensions with the past 3 years?
Briefly explain unemployment reason.
Provide the following information about any high school, college, or trade school attendance.
Certifications & Skills
Are you proficient in using a computer?
Please list any skills, apprenticeships, licenses or certificates that may be job-related or would have value for working at Certified Transmission, such as ASE, ATRA Certification, etc.
Add Certification / Skill
Certified Transmission requires two individuals that we may contact for a personal reference.
Comments / Questions:
Please describe any other skills, honors, and experience that may assist Certified Transmission in employment consideration.
Certified Transmission considers all applicants for all positions without regard, to race, color, religion, creed, gender, national origin, age, disability, marital or veteran status, sexual orientation, or any other legally protected status. A felony conviction will not necessarily bar an applicant from employment. This application form is intended for use in evaluation your qualifications for employment. This is not an employment contract and employment contracts and/or guarantees of employment are not made by Certified Transmission. Please answer all questions completely and accurately. False, misleading or incomplete statements during the interview and/or on this form and/or other employment related forms are grounds for terminating the application process or, if discovered after employment, and prior to reporting to work, you may be required to be examined by a medical professional, designated by Certified Transmission, depending upon the needs of the job, and will be required to complete a medical history form, and undergo testing for the presence of drugs in your body. Smoking is prohibited inside our facilities located in Nebraska, Iowa, Missouri, and Kansas.