Job Application

Job Application.

We are accepting applications for both of the following positions: Dispatcher and Driver.

Use this page to complete and submit a Job Application online. Please notice that many of these fields are required -- the "Submit Application" button will not work until all required fields are filled in.

Applicant Information

Name

Phone

Address

City

State

Zip code

E-mail

How were you referred to Passenger Transit?

Employment Position

Driver at which location?

Dispatcher (Viroqua location only)

Office (Viroqua only)

If hired, on what date can you start working?

Work schedule

Please specify all a.m. and p.m. hours and the days you are available to work.

Sunday

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Personal Information

Have you ever applied to / worked for Passenger Transit before? Yes No

Do you have any friends, relatives or acquaintances working for Passenger Transit ? Yes No

If yes, state name & relationship

If hired, are you willing to submit to and pass a controlled substance test? Yes No

Are you able to perform the essential functions of the job for which you are applying, either with / without reasonable accommodation? Yes No

Have you ever been convicted of a criminal offense (felony or misdemeanor)? Yes No

If yes, please describe the crime - state nature of the crime(s), when and where convicted and disposition of the case.

Education, Training and Experience

High School

High school name

School address

School city, state, zip

Number of years completed

Did you graduate?

Vocational School

Vocational school name

School address

School city, state, zip

Number of years completed

Did you graduate?

Degree / diploma earned

Military Service

Branch

Rank

Years of service

Skills / duties

Related details

Additional Information

Do you speak, write or understand any foreign languages? Yes No

If yes, please indicated which language(s) and level of fluency.

Employment History

Are you currently employed? Yes No

Please describe past and present employment positions, dating back five years. Please account for all periods of unemployment. Even if you have attached a resume, this section must be completed.

Name of Employer

Name of Supervisor

Business Type

Address

City, State, Zip

Phone number

Length of Employment

Reason For Leaving

Position And Duties

May we contact this employer for references? Yes No

Name of Employer

Name of Supervisor

Business Type

Address

City, State, Zip

Phone number

Length of Employment

Reason For Leaving

Position And Duties

May we contact this employer for references? Yes No

Name of Employer

Name of Supervisor

Business Type

Address

City, State, Zip

Phone number

Length of Employment

Reason For Leaving

Position And Duties

May we contact this employer for references? Yes No

References

List below three persons who have knowledge of your work performance within the last four years. Please include professional references only.

First and Last Name

Phone

Address

City, State, Zip

Occupation

Number of years acquainted

First and Last Name

Phone

Address

City, State, Zip

Occupation

Number of years acquainted

First and Last Name

Phone

Address

City, State, Zip

Occupation

Number of years acquainted

Please read and initial each paragraph, then sign and date below.

I certify that I have not purposely withheld any information that might adversely affect my chances for hiring. I attest to the fact that the answers given by me are true & correct to the best of my knowledge and ability. I understand that any omission (including any misstatement) of material fact on this application or on any document used to secure can be grounds for rejection of application or, if I am employed by this company, terms for my immediate expulsion from the company.

I understand that if I am employed, my employment is not definite and can be terminated at any time either with or without prior notice, and by either me or the company.

I permit the company to examine my references, record of employment, education record, and any other information I have provided. I authorize the references I have listed to disclose any information related to my work record and my professional experiences with them, without giving me prior notice of such disclosure. In addition, I release the company, my former employers & all other persons, corporations, partnerships & associations from any & all claims, demands or liabilities arising out of or in any way related to such examination or revelation.

Applicant's signature

Date

An Equal Opportunity Employer

Passenger Transit is an equal opportunity employer. This application will not be used for limiting or excluding any applicant from consideration for employment on any basis prohibited by local, state, or federal law. Applicants requiring reasonable accommodation in the application and/or interview process should notify a representative of Passenger Transit.

Contact Us

8:00 am - 4:00 pm
Monday - Friday

EMail

contact@browncab.net

Phone

608-637-2599

Address

318 West Decker Street
Viroqua, WI 54665