(336) 754-2155 intake@mycctransportation.com

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Employment Application

Employment Application

It is our policy to comply with all applicable state and federal laws prohibiting discrimination in employment based on race, age, color, sex, religion, national origin, disability or other protected classifications.

* Indicates required information

Personal Information

Last Name *
First Name *
Middle Name
Phone *Numbers only. Do not use - or ().
Email *
Address
Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry
Date of birth
Have you ever been involuntarily terminated or requested to resign? *
YesNo
If "Yes" explain:
If hired, can you provide verification of your legal right to work in the United States? *
YesNo
Are you at least 18 years of age? *
YesNo
If required for the position, do you have a valid driver's license? *
YesNo
Have you ever worked under a different name? *
YesNo
If "Yes" name:
Have you ever been convicted of a crime or been a defendant in a civil action for an intentional tort? (Convictions will not necessarily disqualify you for the position.) *
YesNo
If "Yes" list offense, date and disposition of the case:
How were you referred to our company? *

Employment Interests

Position desired *
Date available *
Salary desired *
Would you be willing to work overtime? *
YesNo
Type of employment desired *
Full-timePart-timeTemporary
Days and hours available for work *

Education Information

Highest level of education *
High SchoolBusiness/Trade TechnicalCollege/UniversityPost Graduate
Name and location of highest-level school *
Course of study
Number of years completed *
Did you graduate? *
YesNo
Type of degree or diploma *

Skills

List any skills that are applicable for the position desired.
Foreign languages (indicate proficiency to speak, read or write)

Employment History (Start with current or most recent employer)

Optional Resume File Upload If you have a resume, you may upload it here and skip the EMPLOYMENT HISTORY section. Accepted file formats are .pdf .doc or .docx

Employer 1

Company name
Phone
Address
Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry
Start date
End date
Supervisor
May we contact this employer?
YesNo
Job title
Duties
Reason for leaving

Employer 2

Company name
Phone
Address
Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry
Start date
End date
Supervisor
May we contact this employer?
YesNo
Job title
Duties
Reason for leaving

Employer 3

Company name
Phone
Address
Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry
Start date
End date
Supervisor
May we contact this imployer?
YesNo
Job title
Duties
Reason for leaving

Refererences (List 2 professional and 1 personal)

Professional Reference 1

Full name *
Relationship *
Phone *
Email

Professional Reference 2

Full name *
Relationship *
Phone *
Email

Personal Reference

Full name *
Relationship *
Phone *
Email

Acknowledgment

I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my employment being terminated.
Signature *
Date *

Verification

Please enter any two digits *Example: 12
This box is for spam protection - <strong>please leave it blank</strong>:

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Phone: (336) 754-2155
Fax: (336) 754-2061
Email: intake@mycctransportation.com

Corporate Office:
8137 Old U.S. Hwy 52
Lexington, NC 27295

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