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Authorization

Disclosure

In considering you for employment and, if you are employed, in considering you for subsequent promotion, assignment, reassignment, retention, or discipline, TRAFFIC AND LIGHTING SYSTEMS, LLC (“the Company”) may request and rely upon one or more consumer reports or investigative consumer reports about you that we obtain from a consumer reporting agency, such as SelectForce, Inc.

For explanation purposes:

  • a “consumer report” is a written, oral or other communication of any information by a consumer reporting agency bearing on your credit worthiness, credit standing, credit capacity, character, general reputation, personal characteristics, or mode of living which is used or expected to be used or collected in whole or in part for the purpose of serving as a factor in making an employment-related decision about you. Such information may include, for example, credit information, criminal history reports, or driving records; and
  • an “investigative consumer report” is a consumer report in which information on your character, general reputation, personal characteristics, or mode of living is obtained through personal interviews with your prior employers, neighbors, friends, or associates, or with others who may have knowledge concerning any such items of information. It may also include verification of education. In the event an investigative consumer report is requested about you, you are entitled to additional disclosures regarding the nature and scope of the investigation requested, as well as a written summary of your rights under the Fair Credit Reporting Act (“FCRA”). Under the FCRA, before the Company can obtain a consumer report or investigative consumer report about you for employment purposes, we must have your written authorization. Before we take adverse action on the basis, in whole or in part, of information in that report, you will be provided a copy of that report, the name, address, and telephone number of the consumer reporting agency, and a summary of your rights under the FCRA.

 

If Applicable

Consumer Disclosure

I have read and understand the foregoing Disclosure, and authorize the Company to obtain and rely upon consumer reports or investigative consumer reports in considering me for employment and, if I am employed, in considering me for subsequent promotion, assignment, reassignment, retention, or discipline. By my signature below, I authorize the Company to obtain any such reports and to share the information received with any person involved in the employment decision about me. I also agree that this Disclosure and Authorization in original, faxed, photocopied, or electronic (including electronically signed) form will be valid for any consumer reports or investigative consumer reports that may be requested about me by or on behalf of the Company.

General Information

In Compliance with Federal and State equal opportunity laws, qualified applicants are considered for all positions without regard to race, color, religion, sex, national origin, age, marital status, veteran status, non-job related disability, or any other protected group status.


Or

Education/Qualifications

Education


Experience and Qualifications

List any current or unexpired licenses (including your Drivers License).

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Certifications / Training Received

Experience

Equipment Experience

Violations of Motor Vehicle Laws and Ordinances

List all moving violations for the preceding 3 years.

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Driving Experience

Type of Equipment

Commercial Motor Vehicle Accidents

I certify that the following is true and accurate list of all commercial vehicle accidents and any "Fatalities and Personal Injuries" as a result of said accident in accordance with FMCSA 391.27(7) for the 3 years preceding this application.*

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Statement of Commercial Vehicle License Suspensions

I certify that the following is a true and complete list of facts and circumstances of any denial, revocation, or suspension of any license, permit, or privilege to operate a commercial vehicle.*

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Previous Employers

Start with most current employer. List employers for the previous 10 years. All employers for the last 3 years will be contacted.


Finish & Submit

References

Give the names of three persons not related to you, whom you have known at least one year.

Addresses for preceding 3 years, prior to application.

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Please read the following certification carefully before completing your job application

I, the submitter, certify that the information given by me in this application is true in all respects, and I agree that if the information given is found to be false in any way, it shall be considered sufficient reason for denial of employment or discharge. I authorize the use of any information in this application to verify my statements, and accept as indicated above, I authorize past employers, all references, and any other persons to answer all questions asked concerning my ability, character, reputation, and previous education or employment record. I release all such persons from any liability damages on account of having furnished such information. I consent to such investigations that this employer may make regarding driving records, law enforcement records, credit reports and my general background. I further understand that all applicable portions of this application must be completed or I will be ineligible for consideration for the position for which I am applying.

I understand that turning in this employment application or the granting of an interview is not indicative of establishment of employment between this employer and myself nor for the providing of any benefits. No promises regarding employment have been made to me, and I understand that no promise or guarantee of employment for any specific length of or under any specified circumstances shall be binding unless made in writing by or with the express written consent and authorization of the President/Owner. If an employment relationship is established, I understand that I have the right to terminate my employment at any time and for any reason and that this employer retains the same right.

I understand that, if I am initially offered a position of employment, I may be required to submit to drug and/or alcohol tests which are a condition of employment and that refusal to submit to such tests when asked by this employer shall be sufficient reason for denial for employment or discharge. I understand that if employed, the policies and rules, which are issued by this Traffic & Lighting Systems, LLC, are not conditions of employment and that this employer may revise policies or procedures, in whole or in part, unilaterally at any time.

IMPORTANT
If you do not understand, or if you disagree with any portion of the above certification, DO NOT submit before discussing with this employer.

Submitting this application certifies that this application was completed by me, the submitter, and that all entries on it are true and complete to the best of my knowledge.

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