Position Applying For
Your Full Name (required)
Main Phone (required)
Cell Phone (required)
Your Email (required)
Are you at least 18 years of age?
Upon the signing of this application, I represent that all of the information in this application or which now or hereafter may be given by me in support of my application is true and complete. I authorize the Blue Water Area Transportation Commission (the "Commission") to verify any of the information concerning me, including my former employment, education, credit history, criminal history, or medical history (post offer), with any Individuals, companies, institutions or agencies, and I authorize them and references to release such information as you require including my prior disciplinary employment record without liability for damage incurred in giving any such information and without any obligation to give me written notice of such disclosure that may be require by state or federal law. I also authorize you to release any information requested by any of my prospective or subsequent employers without liability for damage incurred in giving any such information and without any obligation to give me written notice of such disclosure that may be required by state or federal law. I here by release you and them from any liability whatsoever as s result of any such inquiries and disclosures except that this release from liability does not waive or prohibit an individual from filing a charge of discrimination under the laws enforced by the EEOC. I agree that any false Information. Misrepresentation, or omissions, oral or written, provided on the application or in support may disqualify me from further consideration for employment or may subject me to discipline or discharge at any time during the period of my employment.
I agree that if I become an employee of the Commission either party may terminate the employment relationship, with or without cause, at any time, and I further agree that this arrangement may only be altered by a writing directed to me personally and signed by the Commission General Manager. I agree that I shall be bound by the other rules, policies, regulations and terms and conditions of employment of the Commission - as they are from time to time changed, and no additional obligations can be imposed on the Commission except those which have been acknowledged in writing, by the Commission General Manager. I hereby authorize the Commission to deduct from cad and every period of my pay any amounts necessary to offset any damages caused by me or the value of property of money entrusted to me by, or owed by me, to the Commission during the course of my employment
I agree that any action or suit against the Commission, its agents or employees, arising out of this application, my employment or termination of employment Including, but not limited to, claims under State, but not Federal, civil rights statutes, but be brought within 180 days of the event giving rise to the claims or forever barred. I waive any limitation periods to the contrary. I further agree that any damages that I may be awarded in any action or suit shall be limited to ninety (90) days of severance pay. 1 farther agree that III should bring any non-statutory action or claim arising out of my employment against the Commission, in which the Commission prevails, I will pay to the Commission any and all such costs into incurred by the Commission in defense of said claims or actions, including attorney fees.
I hereby consent to the release of my driving record to the Commission.
I understand upon an offer of employment, I will be required to undergo a physical examination prior to employment and such future medical examinations as may be required by the Commission.
I hereby give my consent for the Commission through an authorized testing service of its choice, to collect blood, urine or saliva samples from me and to conduct any other necessary medical tests to determine the presence of alcohol, drugs, or controlled substances, and I hereby release the Commission and the testing service from any liability arising out of such test or its result. Further, I give my consent for the release of the test results and other relevant medical information to authorized Commission management for appropriate review. If I am accepted for employment by the Commission, I hereby consent to be tested in the above manner during my employment when, in the Company's judgment, such testing is appropriate, and I acknowledge that remaining free of illegal drug use and complying with the Company's substance abuse policy is a condition of my employment. I further agree that my employment or any officer of employment is conditional until such time as the results of my post-offer physical and drug screen are known.
Electronic Signature (Required)
A person with a disability or handicap requiring accommodation for completing the application process should notify the Commission Manager as soon as possible.
The Commission is an Equal Opportunity Employer. It is policy of the Commission to afford equal employment opportunity regardless of a person’s race, religion, color, national origin, sex, age, marital status, height, weight, or disability.
Michigan law requires that a person with a disability requiring accommodation for employment notify the employer in writing 182 days after the need is known.
How long have you lived in the state, county or city?
Have you ever worked for the Commission under another name?
If yes, give name:
Is any additinal information relative to a different name you may have used necessary to allow the Commission to check your work record? If so, please explain:
If you are hired, can you provide proof of authorization to work in the United States?
Course or Major
Business or Trade School
Are you able to perform the essential job functions listed for the position applied for with or without reasonable accommodation? (Driver functions are listed further on this application.)
Have you ever worked for the Commission before?
If yes, from when to when?
Reason for leaving?
Names of any relatives employed by BWATC:
Have you ever been discharged (fired) from employment?
If yes, please explain?
Have you ever been convicted of a crime (conviction will not be an absolute bar to employment)?
If yes, please state the nature of each conviction, date, place
Are there any felony charges pending against you?
Who suggested that you apply for a position with the Commission?
Employer Name & Address
Rate of Pay
Supervisor Name & Title
Reason for leaving:
Describe in detail the work performed:
The following applies only to applicants seeking a Driving Position
Must have functional use of arms, legs, feet, hands and fingers (per D.O.T. regulations)
Possess or ability to obtain a Class B Commercial Driver’s license with air brake endorsement
Able to operate hydraulic lift equipment in public transit vehicles
Must be able to communicate orally with general public
Must be able to qualify for employment by successfully passing a D.O.T. physical and drug screen
Good prior driving record with no suspensions or revocations within the past 5 years • Good public relations
Ability to complete logs, time sheets or repair orders legibly
Must be at least 21 years of age
Knowledge of the Commission service area (City of Port Huron and surrounding areas)
High School Education
Experience dealing with senior citizens and individuals with mental or physical handicaps
Experience operating large vehicles
All applicants for positions requiring a Class B Commercial Driver’s license must fill out these sections
How many years have you been driving?
Are you required to wear glasses/contacts?
Do you have 20/20 vision?
How many years driven commercially?
State & CDL or OP License #
Restrictions (if any)
Has any license you ever held been:
Have you any other driving experience?
What size of vehicle?
The Age Discrimination in Employment Act of 1967 prohibits discrimination on the basis of age with respect to individuals who are at least 40 years of
age. Michigan law also prohibits unlawful age discrimination.
How many accidents have you been involved in, regardless of severity?
How many as an operator of commercial vehicles?
How many as an operator of private owned cars or trucks?
City & State
Brief Description of the Accident
List all traffic violations, other than parking tickets for which you have ever been convicted
Date of Violation
Crime, Infraction or Offense
Name of Court
Date of Conviction
Disposition or Fine
Indicate Current Traffic Points
Government agencies at times require periodic reports on the sex, ethnicity, handicapped, veteran and other protected status of applicants. This data is
for analysis and possible affirmative action only. SUBMISSION OF THIS INFORMATION IS VOLUNTARY.
—Please choose an option—MaleFemale
—Please choose an option—YesNo
—Please choose an option—YesNo
—Please choose an option—American Indian or Alaska NativeAsianBlack or African AmericanNative Hawaiian or Pacific IslanderWhite or CaucasianOther
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