Welcome, Applicant!

This application must be completed in one session and may not be resumed later, so it is important to have all necessary information before proceeding. You will need the following information to complete the application:

  • Three years residence history
  • Three years of previous employment history, including any gaps in employment
    • Full addresses, phone numbers, and employment dates needed for previous employers
  • Three years of traffic conviction and violation history
  • Three years of motor vehicle accident history
  • Copy of driver’s license
Okay

Jasa Transit, Inc.
Employment Application


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Step 1 of 8 - Personal Information  


In compliance with Federal and State equal employment opportunity laws, qualified applicants are considered for all positions without regard to race, color, religion, sex, national origin, age, marital status, veteran status, non-job related disability, or any other protected group status.
 
 
*Required
Application Date (mm/dd/yyyy)  
*
 
First Name
*
 
Middle Initial
Last Name
*
 
Social Security #
*
     
Current Address
*
 
 
City
*
 
State
*
 
Zip Code
*
     
Time at this Address Year(s)
*
  Month(s)
*
 
Home Phone Number 
*
 
Work Phone Number
Email Address
*
 
Date Of Birth (mm/dd/yyyy)  
*
 
Position(s) Applied For (150 char max)
Do you have the legal right to work in the United States?    
*
 
Can you provide proof of age?   
*
 
Have you worked for this company before?    
Who referred you?
Rate of pay expected
Have you ever been bonded? (Answer only if a job requirement)   
Name of bonding company
Can you perform, with or without reasonable accommodation, the essential functions on the job (applied for)?   
*
 
If no, explain if you wish.



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