Interview Questions

By providing the information requested below and signing this document, you acknowledge and agree to the following:

You authorize Starr Transit to collect and use the information provided herein for the purposes stated in this document. You certify that all information provided is accurate and complete to the best of your knowledge. Your electronic or physical signature on this document signifies your consent and agreement to the terms outlined herein.

Applicant's Name

First NameLast Name

Date

1. Have your driving privileges ever been suspended or revoked in any state? If yes, state the reason and the length of the suspension or revocation. Question where and why. NOTES:

2. Have you ever been convicted of a crime? Drug or narcotic charges? Theft from any employer? If yes to any of these questions, when, where and what were the nature of the charges? NOTES:

3. Have you even been convicted of Driving while Intoxicated? Tested positive for a controlled substance? Had a breath alcohol concentration of 0.04 or greater? If yes, state who, what, when, and where. NOTES:

4. Have you had any moving violations the past three years, (in a personal or commercial vehicle), in any state? State the nature of the conviction(s), penalty, type of vehicle driven at the time of the violation and the state. NOTES:

5. Have you had any accidents in the past five years, (in a personal or commercial vehicle), in any state? If yes, what types of accidents, what type of vehicle(s) driven at the time of the conviction, number of injuries or deaths, when, where and describe in detail. NOTES:

6. Have you ever been terminated or asked to resign by an employer? If, yes, state the company name, when, where and why. NOTES:

7. Have you ever received any warning letters, suspensions, or other types of disciplinary action from any employer? If yes, when, where and state the nature of the charges. NOTES:

Applicant's Signature

Applicant's Printed Name

First NameLast Name

Interviewer's Signature

Interviewer's Printed Name

First NameLast Name

I have read the questions and the answers that I provided during this interview. The answers that I have provided are truthful an accurate to the best of my knowledge. I understand that if I have intentionally provided false or misleading answers, it could result in my disqualification from consideration for employment at Starr Transit.