NAME ________________________________________________________ SS # ______________________________
ADDRESS : ________________________________________________________________________________________
CITY _______________________________________
STATE ______________________ZIP ___________________
HOME PHONE __________________ WORK PHONE
____________________Cell
Phone ______________________
FAX NUMBER ______________________________ E-mail ________________________________________________
BIRTHDATE ___________________OCCUPATION ______________________________________________________
DL #: ________________ STATE: ________CLASS: ____________RESTRICTIONS: ___________________________
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Describe any Construction Experience ___________________________________________________________________
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Describe any Railroad Experience ______________________________________________________________________
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| I can work on MATA projects at the following facilities: | |
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PLEASE DESCRIBE ANY HEALTH CONDITONS YOU MAY HAVE ______________________________________
________________________________________________________________________________________________
Emergency
Notification:
NAME ____________________________________________ PHONE # with AREA CODE _____________________
Additional phone #: ________________________________________RELATIONSHIP_________________________
ADDRESS_____________________________________________________________________________________
DOCTOR: __________________________________________ PHONE # with AREA CODE _____________________
HAVE YOU EVER BEEN CONVICTED OF A FELLONY?
Yes
No. IF SO, EXPLAIN:
_____________________________________________________________________________________________
_____________________________________________________________________________________________
HAVE
YOU BEEN INVOLVED IN AN AUTO ACCIDENT IN WHICH YOU WERE FOUND TO BE AT FAULT
WITHIN THE LAST TWO (2) YEARS?
Yes
No
HAVE
YOU EVER HAD YOUR DRIVERS LICENSE SUSPENEDED OR REVOKED?
Yes
No IF YES, WHEN?
_____________________________________________________________________________________________
BY
SIGNING THIS APPLICATION, I UNDERSTAND THAT MY
FAILURE TO ANSWER ANY OF THE ABOVE
QUESTIONS TRUTHFULLY IS GROUNDS FOR DISMISSAL FROM THE SERVICE.
Personal References:
NAME ____________________________________________ PHONE # with AREA CODE ______________________
RELATIONSHIP______________________________ COMPANY __________________________________________
Name ______________________________________________ Phone # with Area Code ________________________
Relationship_________________________________ Company ___________________________________________
Name ______________________________________________ Phone # with Area Code ________________________
Relationship_________________________________ Company ___________________________________________
MAY
WE CALL THESE REFERENCES?
Yes
No
Signed ______________________________________________________ Date______________________________
Mail to: McKinney Avenue Transit Authority, 3153
Oak Grove, Dallas, TX 75204 or FAX to: 214.855.5250.
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©
2002 The McKinney Avenue Transit Authority, 3153 Oak Grove at Bowen,
Dallas, TX 75204
Voice: 214.855.0006 - FAX: 214.855.5250. Last updated February 27, 2002. Contact our: Webmaster, Executive Administrative Director, Advertising Representative, Chief Operations Officer |