Contractor Information
Title
Please Select
Paratransit Operator
Administration
Clerical Support
Start Date
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Personal Information
Legal Full Name
First Name
Last Name
If you have ever changed your name or used other names, kindly provide that name below.
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Cell Phone Number
Format: (000) 000-0000.
Secondary Phone Number
Format: (000) 000-0000.
Email
example@example.com
Birthday
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
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Emergency Contact Information
Primary Emergency Contact Name
First Name
Last Name
Primary Emergency Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Primary Emergency Contact Relation
Secondary Emergency Contact Name
First Name
Last Name
Secondary Emergency Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Secondary Emergency Contact Relation
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Professional Information
List all driver licenses you have obtained in the last three years, including those from different states or countries, if applicable.
Rows
State
License Number
Class
Expiration Date
Current License
Previous License
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Starting with your most recent work experience, provide a complete record of all employment or contactor services during the past five years.
Rows
Title
Company
Start Date
End Date
Reason for Leaving
Most Recent
Previous
Previous
Previous
Previous
What is your highest level of education?
Please Select
Elementary School
High School Graduate/GED
College Degree
Trade School Certification
Have you ever served in the United States Military?
Please Select
Yes
Yes, and I am on Active Duty
No
Paratransit Operators contracted by K&J Express must have their Medicar Transportation Safety Certification and CPR/First Aid certifications as well as any other trainings or workshops the company assigns. Do you currently hold any applicable certifications? Kindly submit a copy of these certifications via email to KJExpressTransit@outlook.com.
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Paratransit Operator Records
Paratransit Operators completing this form may SKIP this page by scrolling down and selecting "Submit," as these documents must be completed and submitted in person with a K&J Express Transit administrator.
Background Check
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CPR/First Aid
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Fuel Card Policy
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Liability Waiver
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License
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Medicar License
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MVR
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Paratransit Operator's Policies and Procedures
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