Non-Driver Employment Application

Personal Information

Have you ever working for SJ Transportation in the past? If yes, please list dates (To - From)

Address History

Please provide 3 years of address history, beginning with your current address. Current address is required.

Previous Addresses (if applicable)

If you have more addresses to enter, please use the Additional Detail section at the end of this application.

Employment History

Please list previous 3 employers.

Street, City, State, Zip
Street, City, State, Zip
Street, City, State, Zip

Degrees, Certifications, Etc.

Additional Comments or Information

If you need to provide additional information from any fields earlier in this application, please do so here.

Release

Please Read Carefully

I authorize SJ Transportation Co., Inc. to make such investigations and inquiries of my personal, employment, financial or medical history and other related matters as may be necessary in arriving at an employment decision. (Generally, inquiries regarding medical history will be made only if and after a conditional offer of employment has been extended). I hereby release employers, schools, health care providers and other persons from all liability in responding to inquiries and releasing information in connection with my application. In the event of employment, I understand that false or misleading information given in my application or interviews(s) may result in discharge. I understand also, that I am required to abide by all rules and regulations of the Company. I understand that information I provide regarding current and/or previous employers may be used, and those employer(s) will be contacted, for the purpose of investigating my safety performance history as required by 49 CFR 391.23(d) and (e). I understand that I have the right to: Review information provided by previous employers; Have errors in the information corrected by previous employers and for those previous employers to re-send the corrected information to the prospective employer; and Have a rebuttal statement attached to the alleged erroneous information, if the previous employer(s) and I cannot agree on the accuracy of the information.

You will be asked to sign a hard copy of this release at the time of interview.

** This certifies that this application was completed by me and that that all entries on it and information in it are true and complete to the best of my knowledge. Signature will be required at time of interview.