Employment Application Online Form | Antelope Valley Transit Authority

Personal Information

First Name

Middle Initial

Last Name

Street Address

City

State

Zip Code

Home Phone

Cell Phone

Email Address

Position Information

Position Desired

Starting Salary Desired

I am available to work (select all that apply)

Full-Time Part-Time Temporary

Days Available

Hours Available

Describe any training or special experience related to the position you are applying for

Were you previously employed by AVTA or any of its business associates?

If yes, when and where?

Names of Friends/Relatives employed by AVTA

How were you referred to us?

In accordance with the Federal Immigration and Reform Act of 1986, if you are employed by AVTA, you will be asked to provide documentation that verifies your legal right to work in the United States. If you are unable to provide acceptable documentation, AVTA cannot legally employ you. Can you provide such documentation?

Do you authorize a background investigation?

I understand that the Authority may obtain Public Records about me as part of a background investigation and that I may waive my right to receive a copy of such Public Records by checking the box below:

I understand

Are you over the age of 18, or can you provide a work permit?

Education

High School

Name / Location

Subjects Studied

Degrees or Credits

Junior College / Trade School

Name / Location

Subjects Studied

Degrees or Credits

University / College

Name / Location

Subjects Studied

Degrees or Credits

Professional Licenses / Certificates

License / Certificate

License / Cert Number

Date Issued

Expiration Date

Additional Professional License / Certificate

License / Certificate

License / Cert Number

Date Issued

Expiration Date

Work History

List most recent employer first. You may include military service and training. NOTE: YOU MUST COMPLETE THIS SECTION EVEN IF ATTACHING A RESUME. FAILURE TO COMPLETE COULD JEOPARDIZE CONSIDERATION.

Employer 1

Employer Name

Telephone

Type of Business

Address

Supervisor Name & Position

Position Held

Start Date

End Date

Reason for Leaving

May we contact this employer?

Responsibilities

Employer 2

Employer Name

Telephone

Type of Business

Address

Supervisor Name & Position

Position Held

Start Date

End Date

Reason for Leaving

May we contact this employer?

Responsibilities

Employer 3

Employer Name

Telephone

Type of Business

Address

Supervisor Name & Position

Position Held

Start Date

End Date

Reason for Leaving

May we contact this employer?

Responsibilities

Work References

Reference 1

Name

Professional Relationship

Work Phone

Home Phone

Reference 2

Name

Professional Relationship

Work Phone

Home Phone

THE FOLLOWING POINTS ARE VERY IMPORTANT. PLEASE READ THEM CAREFULLY BEFORE SIGNING THIS APPLICATION

I authorize investigation of all statements contained in this application. I will not hold AVTA or any of my previous employers liable in any respect if an employment offer is not forthcoming, is withdrawn, or if my employment is terminated as a result of misrepresentation or omission of facts on this application. I understand that if I am employed by AVTA, additional personal data may be required for determination of benefits, statistical purposes, and legal compliance.

I understand that all offers of employment are also conditional on my successfully completing a background and drug and alcohol screening. This will be performed at AVTA's designated medical facility and at AVTA's expense. I further understand that if this screening is not successful, all offers of employment will be withdrawn. I also understand that AVTA's policy prohibits the use, sale, or possession of illegal drugs or non-prescribed controlled substances, as well as alcohol, while on the Authority's time and that if I am employed by AVTA such activity may result in immediate termination of my employment.

I also understand that if I am employed by AVTA, my employment is "at will." This means that my employment may be terminated by me or AVTA, at any time, for any reason, with or without notice. In addition, the terms and conditions of my employment may be changed at any time, with or without notice, including but not limited to promotion, demotion, transfer, compensation, benefits, duties and location of work. I further understand that my status as an "at will" employee cannot be changed except through written agreement signed by the Executive Director or the decision of the Board of Directors of AVTA.

I HEREBY ACKNOWLEDGE THAT I HAVE READ AND UNDERSTAND THE ABOVE AND AGREE TO EACH AND ALL OF THESE STATEMENTS:

I agree to the above statement

Self-Identification of Gender & EEO Status

As an Affirmative Action Employer, AVTA is required and requests the cooperation of all interested applicants in identifying their gender and EEO status. This information will be summarized and included in our current Affirmative Action Program without disclosing the name of the individual. Please be advised that all information obtained on this form will be kept separate from the Application for Employment and in a separate confidential file. Thank you in advance for your cooperation.

Full Name

Position Applied For

Gender

EEO Status / Race or Ethnic Identity

Hispanic or Latino: A person of Cuban, Mexican, Puerto Rican, South or Central American or other Spanish culture or origin, regardless of race. White (Not Hispanic or Latino): A person having origins in any of the original peoples of Europe, the Middle East, or North Africa. Black or African-American (Not Hispanic or Latino): A person having origins in any of the Black racial groups of Africa. Asian (Not Hispanic or Latino): A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian subcontinent including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam. Native Hawaiian or Other Pacific Islander (Not Hispanic or Latino): A person having origins in any of the original peoples of Hawaii, Guam, Samoa, or other Pacific Islands. American Indian or Alaskan Native (Not Hispanic or Latino): A person having origins in any of the original peoples of North and South America (including Central America), and who maintains tribal affiliation or community attachment. Two or More Races (Not Hispanic or Latino): All persons who identify with more than one of the above five races.