Lefleur Transportation :: Career Opportunities

Application For Employment ver 2

LeFleur Transportation is an Equal Opportunity Employer.

(This application is only valid for the position(s) listed and is void after 30 days.)

SELECT A POSITION YOU ARE APPLYING FOR

Position :

Location :

Application must be complete.

Last Name*

First Name*

Middle Name

Address*

City*

County*

State*

Zip*

Time at this address

Mailing Address if Different

Home Phone*

Cell Phone

Email:

Social Security Number*

Date Available

Working Hours/Days

PLEASE READ AND ANSWER ALL THE QUESTIONS BELOW

In order to be considered for a position, LeFleur Transportation will run a criminal background check. Are you willing to release this information to us? (your signature authorizes release of this information)

Do you know of any reason(s) that might make it difficult for the LeFleur Transportation to obtain surety bond insuring your honesty?

If yes, please explain.

How were you referred to LeFleur Transportation?

Please note the total number of days absent from school or work this past year.

Have you previously been associated with LeFleur Transportation?

If yes, when and where?

Do you have any relatives currently associated with us?

If yes, please give the name(s).

Please list all addresses at which you have lived within the past 10 years.

Are you presently authorized to work in the U.S. on a full-time basis?

Have you ever been convicted of, pled guilty to, or paid a fine for any criminal offense? (a conviction will not necessarily disqualify an applicant).

If yes, please explain.

DRIVER'S LICENSE

Do you have a commercial driver's license?

All background information obtained shall be utilized to assist in verification of the employment application. Retrieval and usage of this information complies with all Equal Opportunity Commission, Americans With Disabilities Act, and the Fair Credit Reporting Act (Laws, Rules, and Regulations). LeFleur Transportation is an Equal Opportunity Employer, and does not discriminate as to race, color, gender, national or religious origin, age, disabilities or any other characteristic protected by law. I understand that the request for Date of Birth is for permissible purpose and not for purposes prescribed by the laws prohibiting age discrimination. Date of Birth is required only for individuals who will be operating LeFleur Vehicles for the purposes of obtaining a Motor Vehicle record.

What class? Date of Birth (persons applying for driving positions only)

LeFleur drivers must have seven years experience as a licensed driver.

How many years have you held a valid driver's license?

If you are applying for a driving position, will you provide LeFleur Transportation with a current motor vehicle record (must be dated within 30 days of application date)?

If no, please explain.

Do you have driving experience?

If yes, please list and describe the types of vehicles have you driven?

Have you ever been known by or used any other name?

If yes, please list the other social security and drivers license numbers.

REFERENCES

Please provide the name, address and phone number of three (3) references who are not related to you and are not previous employers.

EDUCATION

Education	High School
School Name
Address, City, St, Zip
Did you graduate?
Degree received
Course of study
Overall grade point average
List any specialized Training or apprenticeships
List any honors received

Education	Undergraduate
School Name
Address, City, St, Zip
Did you graduate?
Degree received
Course of study
Overall grade point average
List any specialized Training or apprenticeships
List any honors received

Education	Graduate
School Name
Address, City, St, Zip
Did you graduate?
Degree received
Course of study
Overall grade point average
List any specialized Training or apprenticeships
List any honors received

Education	Other
School Name
Address, City, St, Zip
Did you graduate?
Degree received
Course of study
Overall grade point average
List any specialized Training or apprenticeships
List any honors received


Are you planning further studies? If yes, where and when?
Types of Courses:	Would you be a student?

JOB SKILLS

Describe job-related skills (i.e. computer software capabilities, typing (wpm), accounting, data entry, collections, etc.)

EMPLOYMENT HISTORY

List your current and ALL prior employers for previous 5 years Start with your present or last job, including any military service, part-time or volunteer activities. Use a separate sheet if necessary to complete any of this information. A resume will not be considered.


Current or Most Recent Employer:	Phone	Employed

Address	From To
	Start Final Pay
City / State	Duties

Job Title	Supervisor

Reason for Leaving
Have you been disciplined, counseled, warned, asked to resign or discharged at this organization? If yes, explain.

Employer No 1:	Phone	Employed

Address	From To
	Start Final Pay
City / State	Duties

Job Title	Supervisor

Reason for Leaving
Have you been disciplined, counseled, warned, asked to resign or discharged at this organization? If yes, explain.

Employer No 2:	Phone	Employed

Address	From To
	Start Final Pay
City / State	Duties

Job Title	Supervisor

Reason for Leaving
Have you been disciplined, counseled, warned, asked to resign or discharged at this organization? If yes, explain.

Employer No 3:	Phone	Employed

Address	From To
	Start Final Pay
City / State	Duties

Job Title	Supervisor

Reason for Leaving
Have you been disciplined, counseled, warned, asked to resign or discharged at this organization? If yes, explain.

Employer No 4:	Phone	Employed

Address	From To
	Start Final Pay
City / State	Duties

Job Title	Supervisor

Reason for Leaving
Have you been disciplined, counseled, warned, asked to resign or discharged at this organization? If yes, explain.

Have you ever been disciplined, counseled or discharged by any employer?

If yes, explain

UNEMPLOYMENT HISTORY

From	To	Please list and explain any periods of time of four weeks or more that you were not working
1.
2.
3.
4.

ACCIDENTS

FAILURE TO LIST ALL ACCIDENTS MAY RESULT IN YOUR DISQUALIFICATION.

Have you been involved in any accident during the past 5 years in any type of vehicle; regardless of whether you feel they were your fault or not?

Date	Type Vehicle	Whose Fault	Fatalities?	$ Amount of All Damage

Details

Date	Type Vehicle	Whose Fault	Fatalities?	$ Amount of All Damage

Details

Date	Type Vehicle	Whose Fault	Fatalities?	$ Amount of All Damage

Details

Date	Type Vehicle	Whose Fault	Fatalities?	$ Amount of All Damage

Details

TRAFFIC VIOLATIONS

FAILURE TO LIST ALL TRAFFIC VIOLATIONS MAY RESULT IN YOUR DISQUALIFICATION.

Have you had any traffic violations (other than parking violations) for which you have been convicted of forfeited bond or collateral during the past 5 years?

Traffic Conviction(s): Describe	Date	City & State	Penalty

PLEASE READ CAREFULLY

I certify that the information which I have provided in this application is true and complete to the best of my knowledge and that I have withheld no information or other response that, would, if disclosed, affect this application unfavorably. I understand that any misleading or incorrect statements or responses may render this application void and may result in the immediate cancellation of my agreement regardless of the point in time at which the misleading or incorrect statement or response was discovered.

I understand that LeFleur Transportation may conduct an investigation concerning my character, general reputation, mode of living, employment history, job performance, criminal records, motor vehicle records and credit history. I authorize LeFleur Transportation to obtain, and any person, corporation, or governmental unit whom LeFleur Transportation contacts to release to LeFleur Transportation all information known to them regarding my character, general reputation, mode of living, employment history, job performance, criminal records, motor vehicle records, credit history, and other qualifications, whether or not it is in their records. I hereby release both LeFleur Transportation and any and all persons, corporations, governmental units, and law enforcement agencies contacted by LeFleur Transportation from any and all liability for any damage flowing from the disclosure of this information and LeFleur Transportation's action thereon.

I agree to submit myself, whenever requested by LeFleur Transportation to a physical examination by medical personnel designated by LeFleur Transportation and to testing for the presence of alcohol and other drugs or substances by medical personnel designated by LeFleur Transportation. I understand and agree that any positive test result, or the refusal to submit to such testing, may result in disciplinary action up to, and including, termination. LeFleur Transportation is a drug free workplace.

I acknowledge that LeFleur Transportation reserves the right to inspect all property (including vehicles, purses, lockers, desks, lunch boxes, packages, and other containers) on LeFleur Transportation's premises and I agree to allow and to cooperate with such inspections. I also agree that LeFleur Transportation has permission to photograph me and to utilize the photographs in furtherance of LeFleur Transportation's business. I understand that LeFleur Transportation and its employees will, from time to time, monitor my performance and activities under the agreement while I am working or while I am on LeFleur Transportation property, by electronic, video and/or voice transmittal and receiving equipment and telephonic monitoring devices. LeFleur Transportation has my permission to engage in such monitoring and I fully release and hold harmless LeFleur Transportation, its officers, employees and agents of any claim or complaint and damages whatsoever that I may have against them relating to, directly or indirectly, to this monitoring activity.

I further acknowledge and understand that LeFleur Transportation has the unilateral right, at any time and for any reason, to terminate my employment with or without notice. I further understand and agree my employment is not for any specific term or period of time, and that LeFleur Transportation may terminate my employment with or without cause, with or without notice, and without further obligation to me, at the sole and absolute discretion and will of LeFleur Transportation. I understand that no representative of LeFleur Transportation, other than the Chief Executive Officer, has any authority to enter into any agreement for any specified period of time, or to make any agreement contrary to the foregoing, and then only by a written individual employment agreement, signed by the CEO.

I understand the Company's receipt of this application does not entitle me to an agreement to become an employee. This application will be considered only for position for which I apply and will become void and no longer considered thirty (30) calendar days from the date of this application.

My signature below certifies that the application for employment presented to you was completed by me and all entries are true and complete to the best of my knowledge. I also agree that falsified information and significant omissions may result in my disqualification now or any time. I understand that my qualification can be terminated, with or without cause, at any time at the discretion of the company or myself. I authorize all persons and/or institutions to provide relevant information, including my alcohol and controlled substance testing and accident history that may be required to complete my qualification and I agree to release them from any land all liability for supplying this information. I understand this is not a contract and does not alter the at-will status of my employment with LeFleur Transportation. This should not be considered a promise of guarantee of consideration for employment with LeFleur Transportation.

By submitting this application electronically, I certify that I personally completed this application and that all of the information is true and correct. I hereby request and authorize LeFleur Transportation to cause to be conducted, at any time, an investigation of my background for qualification purposes, which may include, but is not limited to, any information relating to my character, general reputation, personal characteristics, mode of living, criminal history, past work experience, educational background, alcohol or drug test results, or failure to submit to an alcohol or drug test, or any other information about me which may reflect upon my potential for employment gathered from any individual, organization, entity, agency, or other source which may have knowledge concerning any such items of information. In connection with my application for employment, I understand that consumer reports which may contain public record information may be requested from DAC Services. I understand that the completion of this form does not assure me of a position with any company or obligate any company in any way. I have completed this application of my own free will and hold Total LeFleur Transportation harmless of all liability for providing this application for my use.

Electronic Signature: By typing your name and date into the text boxes; you are signing this application. You agree to its terms and conditions of your signature thereto may be implied.

Date: * Applicant Signature: *