Application for Employment Revised

Application Instructions and Information Sheet

Thank you for applying with the Regional Transportation Authority. Your interest in employment with the Regional Transportation Authority is greatly appreciated. We want this to be a positive experience for you. Please take a few moments to review the instructions prior to completing your application.

Print legibly or typewrite. This application is part of the examination process. Your application must be complete when submitted. Make sure the application is signed and dated in ink before it is turned in.
Follow the instructions on the application for employment. Complete an application ONLY if you are applying for a specific job vacancy. You must complete a separate application for each position.
Make sure the proper job title appears on each application. We only accept applications for posted position vacancies. Proof of highest level of education must be attached.
You application should clearly describe how you meet the minimum requirements (education, experience, knowledge, skills and abilities) for the job. You may attach a separate sheet(s) to specifically explain how you meet each of the requirements listed on the job posting.
All RTA positions require proof of complete education and valid driver’s license.
No applicant should have no more than two moving violations or accidents in the past three years, no more than one DWI/DUI in a lifetime, and no DWI/DUI in the past five years.

Incomplete applications will not be considered. Resumes will ONLY be accepted with your completed application. Resumes will be accepted only for whatever additional information it contains, but not in place of a completed application. It is the applicant’s responsibility to insure that the application is received within the posting period. Late applications will be rejected.

If assistance is required, either in filling out the application forms or special accommodations please contact a member of the RTA Human Resources Team in the Human Resources Department. The RTA will provide accommodations for person with disabilities in accordance with the Americans with Disabilities Act.

For information regarding job vacancies you may contact the Texas Workforce Commission or visit our website on the Internet at www.ccrta.org. If you live in the Corpus Christi Area, you may also visit our Operations Offices located at 5658 Bear Lane Corpus Christi, TX 78405.

What happens to your application after you leave it with us?

Your application will be forwarded to the Human Resources Department after the job closes. The application will be screened for minimum qualifications related to the job vacancy notice. If you meet these qualifications, your application will be forwarded to the Department that advertised the position. If you are selected for a personal interview, the Human Resource Department will contact you. Only applicants who are interviewed will be notified of the final selection process via written communication.

Applicants who are offered employment with the RTA will be required to pass a drug and alcohol test, an employment physical, and agree to abide by RTA’s Policies, as a condition of employment.

THANK YOU FOR CONSIDERING EMPLOYMENT WITH THE CORPUS CHRISTI REGIONAL TRANSPORTATION AUTHORITY

Position Applying For:

Today’s Date

Referral Source:

PLEASE PRINT OR TYPE

Email address

Last Name

First Name

Middle Initial

Address

Apt. No.

City

Telephone:

Alternate Phone #:

State Zip Code

EMPLOYMENT HISTORY:

This information will be the official record of your employment history and must accurately reflect all significant duties performed. Summaries of experience should clearly describe your qualifications.

INCLUDEALL EMPLOYMENT FOR THE PAST 10 YEARS BEGINNING WITH YOUR CURRENT OR LAST POSITION AND WORK BACK TO YOUR FIRST.
Employment history should include each position held, even those with the same employer
EMPLOYERS’ MAILING ADDRESSES MUST BE COMPLETE.

If you need additional space to adequately describe your employment history, you may use this employment history sheet or attach a typed employment history providing the same information in the same format as this application form.

Failure to complete information may result in disqualification.

New Form

Position Title:

Employer:

Mailing Address:

Hidden

Mailing Address__OLD

City & State/ZIP:

Employer’s Telephone No.

Immediate Supervisor Name:

Title:

If supervisory, number of employees you supervised:

Full-Time
Part-Time
Summer
Temp/Projec

From

To

Current/ Final Salary

Summary of Experience

Specific reason for leaving:

Technical
Non-Managerial
Supervisory/Managerial

New Form

Name

First Middle Last

Position Title:

Employer:

Mailing Address:

Hidden

Mailing Address__OLD

City & State/ZIP:

Employer’s Telephone No.

Immediate Supervisor Name:

Title:

If supervisory, number of employees you supervised:

Full-Time
Part-Time
Summer
Temp/Project

From

To

Current/ Final Salary

Technical
Non-Managerial
Supervisory/Managerial

Summary of Experience:

Specific reason for leaving:

New Form

Position Title:

Employer:

Mailing Address:

Hidden

Mailing Address__OLD

City & State/ZIP:

Employer’s Telephone No.

Immediate Supervisor Name:

Title:

If supervisory, number of employees you supervised:

Full-Time
Part-Time
Summer
Temp/Project

From

To

Current/ Final Salary

Technical
Non-Managerial
Supervisory/Managerial

Summary of Experience:

Specific reason for leaving:

New Form

Position Title:

Employer:

Mailing Address:

Hidden

Mailing Address__OLD

City & State/ZIP:

Employer’s Telephone No.

Immediate Supervisor Name:

Title:

If supervisory, number of employees you supervised:

Full-Time
Part-Time
Summer
Temp/Project

From

To

Current/ Final Salary

Technical
Non-Managerial
Supervisory/Managerial

Summary of Experience:

Specific reason for leaving:

EDUCATIONAL HISTORY:

All positions require High School Diploma or GED; please provide proof of education

Do you have a High School diploma or GED?

Yes
No

High School Graduate School Name/City

G.E.D. Test Center/City

If so, what type:

Year of Graduation

Year of Completion

ADDITIONAL ACADEMIC/VOCATIONAL/BUSINESS EDUCATION(List only those relevant to position)

Name of School & City	Areas of Study	Semester Hours	Degree Received

CURRENT LICENSES/CERTIFICATES/REGISTRATIONS, INCLUDING DRIVER'S LICENSE:

LICENSE TYPE	LICENSE NUMBER	ISSUING AGENCY OR STATE	EXPIRATION DATE

Please Answer YES or NO; explain any YES answers below.

1. Have you previously worked for any department of the Regional Transportation Authority?

Yes
No

If yes, reason for leaving

Dates employed:

2. Have you any relatives now working for the Regional Transportation Authority?

Yes
No

If yes, name(s)

Relationship(s)

3. Have you been: (Check for each)

Fired:

Yes
No

Asked to resign:

Yes
No, Or

Laid Off: From any Job?

Yes
No

Use this space to provide additional information for any YES answers above.

4. Do you have any moving violations in the last three years or DWI/ DUI in a lifetime?

Yes
No

If so, please provide type and dates:

5. Conviction Record: Have you ever been CONVICTED of an offense in an adult court? Please list ALL convictions including dispositions, fines, probations, etc... Check ONE:

Yes
No

If YES, please refer to Application Supplement No. 2 and complete in detail. A conviction will not automatically exclude you from employment consideration. You may omit minor traffic violations for which you paid a fine of $100 or less.

OPTIONAL: You may provide additional verifiable information on your training and/or experience, which may be helpful in assessing your application.

RELEASE AND AUTHORIZATION-READ CAREFULLY BEFORE SIGNING

I certify that I have made no false statement in this application nor have I withheld information in my statements and answers to questions. I am aware that the information given by me in my application will be investigated. I authorize the RTA to obtain from educational institutions and from my former employers, all data needed to support this application. I further understand that falsification or omission of information is grounds for rejection of this application and should I be employed, may be grounds for dismissal. I further understand that this application becomes the property of the RTA and will not be returned. I further understand that any job offer, subsequent employment, and continued employment may be contingent upon my physical/mental ability to perform the job. I understand the Authority will make effort when deemed appropriate to make accommodations. I understand that tests to determine the use/presence of alcohol or other chemical substances may be required. I understand that this application does not represent an employment contract. I understand that should I become employed I will be an At Will employee.

Signature:

RESIDENCY AGREEMENT-READ IF YOU ARE NOT NOW A RESIDENT OF RTA SERVICE AREA

I understand that my employment by the Regional Transportation Authority is contingent upon agreeing to reside within geographic limits established by the Authority, within 90 days from the date of employment and that failure to do so may be grounds for termination.

Signature

Signature:

PRE-EMPLOYMENT DRUG TESTING ACKNOWLEDGMENT

I hereby acknowledge and understand that as part of my application for employment for a position which involves the performance of safety-sensitive functions as defined by 49 CFR Part 655, as amended. I must submit to a urine drug test under the authority of the U.S. Department of Transportation, Federal Transit Administration. I acknowledge and understand that any offer of employment is contingent on the passing of the aforementioned drug test and I will not be assigned to perform a safety sensitive function unless my urine and drug test has a verified negative result having no evidence of prohibited drug use.

Applicant’s signature:

Date:

Applicant’s name:

NOTE: Your application will not be considered for employment of a covered safety- sensitive position unless this acknowledgment is completed and signed.

DOT PRE-EMPLOYMENT TESTING

Have you tested positive, or refused to test, on any pre-employment drug or alcohol test administered by an employer to which you applied for, but did not obtain, safety-sensitive transportation work covered by DOT agency drug and alcohol testing rules during the past (2) two years?

Yes
No

Applicant Signature

Date

*Safety Sensitive positions must also complete Substance Abuse Screening Verification Form*

AUTHORIZATION FOR RELEASE OF CRIMINAL HISTORY RECORD INFORMATION

I understand that, in connection with my application for employment with the Corpus Christi Regional Transportation Authority, a background check will me made which will include a check into criminal records maintained by law enforcement agencies. I authorize the Corpus Christi Regional Transportation Authority to obtain this information, and to use it in considering me as an applicant for employment, and I request that any local, state, or federal law enforcement agency with any criminal history record information to disclose that information to the Corpus Christi Regional Transportation Authority. I hereby release the Corpus Christi Regional Transportation Authority from any and all liability for obtaining or using such information.

Applicant

Date

Printed Name

AUTHORIZATION FOR RELEASE OF MOTOR VEHICLE RECORD INFORMATION

I understand that, in connection with my application for employment with the Corpus Christi Regional Transportation Authority, a motor vehicle check will me made all driving records maintained by law enforcement agencies. I authorize the Corpus Christi Regional Transportation Authority to obtain this information, and to use it in considering me as an applicant for employment, and I request that any local, state, or federal law enforcement agency with any driving history record information to disclose that information to the Corpus Christi Regional Transportation Authority. Corpus Christi Regional Transportation Authority reserves the right to run my motor vehicle report every six months if hired for any of their positions throughout the time of my employment with their organization. I hereby release the Corpus Christi Regional Transportation Authority from any and all liability for obtaining or using such information.

Applicant

Date

Printed Name

STATEMENT OF EEO POLICY

It is the policy of the Corpus Christi Regional Transportation Authority to comply with all federal, state, and local laws regarding Equal Employment Opportunity of all applicants, including Title VII of the Civil Rights Act, the Age Discrimination in Employment Act, and the Americans with Disabilities Act. The Corpus Christi Regional Transportation Authority will consider all applicants equally and without regard to race, color, national origin, sex, age, religion, or disability, but will consider all applicants without regard to any protected class.

In compliance with the Americans with Disabilities Act, the Regional Transportation Authority will reasonably accommodate otherwise qualified individuals with a disability unless such accommodation would pose an undue hardship, would result in a fundamental alteration in the nature of the service or activity or in undue financial or administrative burden.

CONFIDENTIAL AND OPTIONAL TO BE COMPLETED BY APPLICANT

INSTRUCTIONS: Please complete this form by filling out all information. The statistical information will be handled separately from your application.

SSN:

CHECK ONE:

Male
Female

Date of Birth:

PLEASE READ THE DEFINITIONS BELOW. THEN CHECK ONLY ONE OF THE FOLLOWING:

Are you a U.S. citizen?

In what country were you born?

Alien Reg. No.

Are you a veteran of U.S. Armed Forces? (Veteran is defined as someone who has served 180 consecutive days of active duty)

Are you disabled? (See definition below)

Yes
No

If yes, please explain:

Language other than English that you speak fluently:

DEFINITIONS: For purposes of statistical tabulation, the following categories are used.

White (not of Hispanic origin) - A person with origins in any of the original peoples of Europe, North Africa, or the middle East who is not of Hispanic origin.

Black ( not of Hispanic origin) - A person with origins in any of the black racial groups of Africa who is also not of Hispanic origin.

Hispanic - A person of Mexican, Puerto Rican, Cuban, South American or other Spanish culture or origin, regardless of race.

American Indian or Alaskan Native - A person with origins in any of the original peoples of North America and who maintains cultural identification through tribal affiliation or community recognition.

Asian or Pacific Islander - A person with origins in any of the original peoples of the Far East, Southeast Asia, the Indian Subcontinent, or the Pacific Islands. This area includes, for example, China, Japan, Korea, the Philippine Republic, and Samoa.

Disabled - A person who has a physical or mental impairment which substantially limits one (or more) major life activities, or who has a record or history of such impairment, or who is regarded as having impairment.

CONFIDENTIAL

Application Supplement No. 2

Position Applying For: (Separate application must be filled out for each position of interest)

Today’s Date:

PLEASE PRINT OR TYPE

Name:

First Middle Last

Address:

Apt. No.

City:

State:

Zip Code:

Telephone:

Alternate Telephone:

To the Applicant: A conviction record will not necessarily be a bar to employment and factors such as age and time of the offense, seriousness and nature of the violation and rehabilitation will be taken into account.

What were you charged with?

Where were you arrested? (City / State)

When? (Month/Year)

What was the sentence? Probation:

Jail:
Fine:
Other:

(Explain):

When was sentence served?

From:

To:

Where? (Name of Location)

Parole/Probation Officer:

(Name)

(Phone)

(Ending Date of Probation)

Reference Information:

DO NOT WRITE HUMAN RESOURCES USE ONLY.

Reviewed By:

Date

Approved for Referral to:

What were you charged with?

Where were you arrested? (City / State)

When? (Month/Year)

What was the sentence?

Jail:
Fine:
Other:

(Explain):

When was sentence served?

From:

To:

Where? (Name of Location)

Parole/Probation Officer:

(Name)

(Phone)

(Ending Date of Probation)

Reference Information:

File Attachment

Drop files here or

Accepted file types: pdf, doc, docx, txt, Max. file size: 50 MB.

DO NOT WRITE HUMAN RESOURCES USE ONLY

Reviewed By:

Date:

Approved for Referral to:

CAPTCHA

Where would you like to go?

PLEASE PRINT OR TYPE

EMPLOYMENT HISTORY:

Failure to complete information may result in disqualification.

New Form

New Form

New Form

New Form

EDUCATIONAL HISTORY:

PLEASE PRINT OR TYPE

DO NOT WRITE HUMAN RESOURCES USE ONLY.

DO NOT WRITE HUMAN RESOURCES USE ONLY