Transportation Supervisor

Darlene Pellin

Jackson-Milton Schools

13910 Mahoning Ave.

North Jackson, Ohio 44451

330-538-3232 ex. 1406

Jackson-Milton Local Schools

APPLICATION FOR EMPLOYMENT

FOR A SCHOOL BUS DRIVER POSITION

PERSONAL:

DATE OF APPLICATION ______

______

Last Name First Name M.I

Present Address

City State Zip Code

Current Phone Number Cell Phone Number

Birth Date Social Security Number

Have you previously been employed by the Jackson-MiltonLocalSchool District?

______No ______Yes If Yes When ______

In what position ______

EDUCATION:

Name ofLastSchool Attended Year Completed/Graduation Date

______

DRIVING RECORD:

Do you have a current Commercial Drivers License ? ______Yes ______No

Driver’s LicenseNumber______State Issued ______

Class ______Endorsements ______

If Yes: Have you driven a Commercial Vehicle in the last 24 months ?

______Yes ______No

Do you have any points or convictions on your license? ______Yes ______No

If Yes: Reason / Date ______

______

Have you ever been convicted of a misdemeanor or felony? ______Yes ______No

If Yes, Please explain ______

______

PLEASE LIST 3 MOST RECENT EMPLOYERS :

Name of Company ______

Address ______

City/State/Zip ______

Phone ______Contact Person ______

Job Description ______

______

Reason for Leaving ______

Employment Dates From ______until ______

Name of Company ______

Address ______

City/State/Zip ______

Phone ______Contact Person ______

Job Description ______

______

Reason for Leaving ______

Employment Dates From ______until ______

Name of Company ______

Address ______

City/State/Zip ______

Phone ______Contact Person ______

Job Description ______

______

Reason for Leaving ______

Employment Dates From ______until ______

MILITARY SERVICE:

Branch of Service ______

Date of Service - From ______until ______

PLEASE LIST 3 REFERENCES :

Name ______

Address ______

City/State/Zip ______

Phone Number ______Cell Number ______

Company/Relationship ______

Name ______

Address ______

City/State/Zip ______

Phone Number ______Cell Number ______

Company/Relationship ______

Name ______

Address ______

City/State/Zip ______

Phone Number ______Cell Number ______

Company/Relationship ______

Please list below the reason(s) you feel you are qualified to drive a school bus for The Jackson-Milton Local School District also list below reasons why you should be considered for a school bus driver position :

______

Please Read and Sign Below:

The Jackson-MiltonLocalSchool District is an equal opportunity employer and does not discriminate with regard to its employment policies, personnel practices or education programs, regardless of race, color, religion, national origin, disability, gender or age. Applicants for a School Bus Driver position must be at least 18 years of age with two years of driving experience.

The facts set forth in my application for employment are true and complete. I understand that if employed, any false statement on this application may result in my dismissal.

In making this application for employment I authorize the Jackson-MiltonLocalSchool District to contact my previous employers for a job history as well as the Bureau of Motor Vehicles for a complete driving record.

I also understand that it is required by law to be employed at the Jackson-Milton Local School District as a School Bus Driver, I will need to complete an application for a BCI and FBI Background check at a cost to myself of $56.00 (as of 1-1-08) payable to the Mahoning County Educational Service Center by Check or Money Order. This is required every 6 years. (This dollar amount may change based on changes made by the State of Ohio)

Signature of Applicant: ______