Employment Application Form

What job are you applying for?

Full Name*

First NameMiddle NameLast Name

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Phone Number*

Area CodePhone Number

E-mail

What is the best way to contact you: phone, text, or email?

Select the times you are available to work:

Rows	Morning (6AM to 12PM)	Afternoon (12PM to 6PM)	All Day
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday

Full TimePart Time

Do you have any relatives that you know of working for this county?*

YesNo

List any relatives that work for Muskogee County Transit

Have you previously been employed by MCT?*

YesNo

Dates Worked Previously

Are you legally eligible to work in the United States?*

YesNo

Are you willing to submit to drug test and a background check*

YesNo

Have you ever been convicted of a felony or misdemeanor? (conviction will not necessarily disqualify an applicant)*

YesNo

Do you have the ability to perform the job-related functions of the job applied for?

YesNo

Please describe what accommodations would enable you to perform the job applied for.

High School

Name of High School Attended

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Graduated?

Yes

Year Graduated

College

Name of College/University Attended

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Year/ Years Attended

Graduated?

Yes

Area of Study/Degree

Graduate School

Name of Graduate School Attended

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Year/Years Attended

Graduated?

Yes

Area of Study/Degree

Trade School/Other

Name of Trade/Technical/Other School Attended

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Year/ Years Attended

Graduated?

Yes

Area of Study/Degree

Skills

List any relevant skills

Qualifications

List any relevant qualifications

Position Applying for (If Known)

Date You Can Start

MonthDayYear

Drivers: If appying for a driving position please answer the following questions:

Do you have a valid driver's license in this state?

YesNo

License Number:

License Type:

List any moving violations during the last five years

Current/Last Employer

Name of Current Employer or NONE if not Employed

Type of Business

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number

Start Date

MonthDayYear

End Date

Date

Position

Name and Title of Supervisor

May We Contact?

YesNo

Is/Was Employment?

Full TimePart Time

Brief Description of Duties

Reason for Leaving? (If applicable)

Previous Employer

Name of Previous Employer

Type of Business

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number

Start Date

MonthDayYear

End Date

MonthDayYear

Position

Name and Title of Supervisor

May We Contact?

YesNo

Was Employment?

Full TimePart Time

Brief Description of Duties

Reason for Leaving?

Previous Employer

Name of Previous Employer

Type of Business

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number

Start Date

MonthDayYear

End Date

MonthDayYear

Position

Name and Title of Supervisor

May We Contact?

YesNo

Was Employment?

Full TimePart Time

Brief Description of Duties

Reason for Leaving?

Reference 1*

Name of Reference

Relationship*

Years Acquainted*

Phone*

Email

Reference 2*

Name of Reference

Relationship*

Years Acquainted*

Phone*

Email

Reference 3

Name of Reference

Relationship

Years Acquainted

Phone

Email

Cover Letter

Upload a File

Resume

Upload a File

By entering my name, the date, and clicking the submit button below, I certify that all of the information provided by me on this application is true and complete, and I understand that if any false information, omissions, or misrepresentations are discovered, my application may be rejected and, if I am employed, my employment may be terminated at any time.

I authorize you to communicate with all my former employers, school officials, and persons named as references. I hereby release all employers, school officials, and individuals from any liability for any damage whatsoever resulting from giving such information.

In consideration of my employment, I agree to conform to the company's rules and regulations, I also understand that as this county deems necessary, I may be required to work overtime hours or hours outside a normally defined work day or work week.

If employed, I understand and agree that such employment may be terminated at any time for any reason not prohibited by law and without any liability to me for any continuation of salary, wages, or employment related benefits (not required by law).

Signature*

First NameLast Name

Date

Employment Application Form:

Personal Information:

Education:

Skills/Qualifications:

Employment Desired:

Current/Last Employment:

Previous Employment:

References:

Cover Letter & Resume (Optional):

Send Application: