BUS DRIVER APPLICATION

DATE: ________________________

NAME: ________________________________________________ TELEPHONE NUMBER ________________________________

ADDRESS: __________________________________________________________________________________________________

DATE OF BIRTH: _______________________________________________  PLACE OF BIRTH: ____________________________

SOCIAL SECURITY NUMBER: __________________________________________________________________________________

MARITAL STATUS: ________________________________ SPOUSE'S NAME: ___________________________________________

HIGHEST EDUCATION HELD: _________________________ LAST SCHOOL ATTENDED: ________________________________

S.C. DRIVERS LICENSE NUMBER: _____________________________________YEAR HELD LICENSE: _______________________

DO YOU PRESENTLY HAVE A CDL LICENSE?      YES _______________________________ No_____________________________

HAVE YOU BEEN CONVICTED OF A MOVING VIOLATION (S)  IN THE PAST THREE YEARS?

IF YES, WHAT WAS THE CHARGE? ______________________________________________________________________________

_____________________________________________________________________________DATE __________________________

IF YES, WHAT WAS THE CHARGE? ______________________________________________________________________________

_____________________________________________________________________________ DATE _________________________

DO YOU HAVE A DISABILITY, A HANDICAP, OR A MEDICAL CONDITION THAT LIMITS YOUR JOB PERFORMANCE?  

YES? ________________________ NO? ______________________________

IF YES,   PLEASE DESCRIBE AND STATE HOW IT AFFECTS YOUR

ABILITY TO WORK? ___________________________________________________________________________________________

HAVE YOU EVER BEEN CONVICTED OF A FELONY?   YES _____________NO _____________ IF YES, PLEASE GIVE DATE (S)  AND EXPLAIN.  USE SEPARATE SHEET IF NECESSARY.   (NOTE: CONVICTION OF A CRIME IS NOT AN AUTOMATIC BAR TO EMPLOYMENT.   ALL CIRCUMSTANCES WILL BE CONSIDERED. )

DATE: __________________________________ CHARGE: _____________________________________________________________

DATE: __________________________________ CHARGE: _____________________________________________________________

EMPLOYMENT HISTORY:   (RECENT EMPLOYER FIRST)

EMPLOYER: _____________________________________________ FROM: ____________________________ TO: _______________

ADDRESS: _____________________________________________________________________________________________________

JOB TITLE: ____________________________________________________ SUPERVISOR:____________________________________

REASON FOR LEAVING: __________________________________________________________________________________________

_______________________________________________________________________________________________________________

EMPLOYER: _____________________________________________ FROM: ____________________________ TO: ________________

ADDRESS: ______________________________________________________________________________________________________

JOB TITLE: ___________________________________________________ SUPERVISOR:______________________________________

REASON FOR LEAVING: ___________________________________________________________________________________________

________________________________________________________________________________________________________________

REFERENCES:      (DO NOT USE RELATIVES)

GENERAL INFORMATION:

AN  APPLICATION  IS  "ACTIVE"  FOR   TWELVE  MONTHS  (ONE YEAR)  FOLLOWING  THE  DATE  OF   APPLICATION.

BARNWELL  SCHOOL  DISTRICT  45,  AN  EQUAL   OPPORTUNITY  AND  AFFIRMATION  ACTION  SCHOOL  SYSTEM,   IS  ALWAYS  GLAD  TO  RECEIVE  APPLICATIONS  FROM   QUALIFIED  PERSONS.  ASSIGNMENTS  ARE  MADE  IN   ACCORDANCE  WITH  THE  NEEDS  OF  THE  SCHOOL   DISTRICT  45  ACCEPTS  THESE  CONDITIONS.

I  HAVE  READ THIS  INFORMATION  CAREFULLY  AND   CERTIFY  THAT  THE  INFORMATION  GIVEN  IS  CORRECT   AND  COMPLETE.  I  UNDERSTAND  THAT  IF  EMPLOYED,   FALSE  STATEMENTS  ON  THIS  APPLICATION  SHALL  BE   CONSIDERED  SUFFICIENT  CAUSE  FOR  DISMISSAL .   AUTHORIZATION  IS  HEREBY  GIVEN  TO  BARNWELL   SCHOOL  DISTRICT  45  TO  INVESTIGATE  MY  RECORDS   WITH  PAST  EMPLOYERS,  SCHOOLS,  POLICE  AND  FBI   RECORDS.  I  HEREBY  RELEASE  ALL  SOURCES  FROM   ALL  LIABILITY.

DO  NOT  SIGN  BEFORE  READING  GENERAL   INFORMATION.

I HAVE READ THE ABOVE INFORMATION: ____________________________________________________________________________________                                                                                                                                            (SIGNATURE OF APPLICANT)

DATE SIGNED: _______________________________