First Name*
Last Name*
Email Address*
Phone*
Who referred you to this position? Enter their first and last name here.
Do you have a valid driver's license?
No answer Yes No
Do you have a valid Commercial Driver's License?
No answer Yes No
What's your citizenship / employment eligibility?
No answer I am a U.S. Citizen/Permanent Resident Non-citizen allowed to work for any employer Non-citizen allowed to work for current employer Non-citizen seeking work authorization I am a Canadian Citizen/Permanent Resident Other
Are you 18 years of age or older?
No answer Yes No
What languages do you speak fluently?
Earliest start date?
Can you work weekends?
No answer Yes No
Can you work evenings?
No answer Yes No
Can you work overtime?
No answer Yes No
Have you ever been convicted of a felony?
No answer No Yes
If “Yes”, you have been convicted of a felony, please explain the circumstances around the conviction:
References: Please enter names and contact information:
How did you hear about us?*
-- No answer -- Bay Shore Hiring Center Walk-In Career Fair Coram Hiring Center Walk-In Facebook Fire News Hometown Shopper Instagram Library Job Fair Open House Event Other Job Fair Pandora PBA Penny Saver PTA Radio WBAB Radio WBLI Ronkonkoma Hiring Center Walk-In Spotify Tanger Outlet Times Beacon/ Times of Middle Country Virtual DOL Job Fair OTHER
Do you have a valid driver's license?*
-- No answer -- No Yes
Do you have a valid Commercial's Driver's License?*
-- No answer -- No Yes
If you currently hold a CDL license or permit, indicate which class and endorsement: (Example) A/PS, B/PS, C/PS, If none, type N/A.*
What's your highest level of education completed?
-- No answer -- University College High School Middle School Elementary School
Are you 18 years or older?*
-- No answer -- No Yes
What languages do you speak fluently?
Can you work weekends?*
-- No answer -- No Yes
Can you work evening?*
-- No answer -- No Yes
Can you work overtime?*
-- No answer -- No Yes
Have you ever been convicted of a felony?*
-- No answer -- No Yes
Are you on probation?*
-- No answer -- Yes No
If "Yes", you have been convicted of a felony, please explain the circumstances around the conviction:
Have you ever filed an application with us before?*
-- No answer -- Yes No
If yes, provide previous application date:
Have you ever been employed with us before?*
-- No answer -- Yes No
If yes, provide date of employment:
Are you currently employed?
-- No answer -- Yes No
If yes, may we contact your present employer?
-- No answer -- Yes No
Have you ever been denied employment, as a result of a security background check?*
-- No answer -- Yes No
Have you ever been refused employment based on a positive drug or alcohol test?*
-- No answer -- Yes No
A driving abstract will be obtained for persons applying for a drivers position.*
-- No answer -- Yes No
Have you ever had an accident resulting in death or injuries to yourself or others?*
-- No answer -- Yes No
If yes, describe incident.
Have you ever been an employee of this or any other bus or truck company?
-- No answer -- Yes No
If yes, please list them along with years of driving experience in each.
Have you ever been denied a license, permit, or privilege to operate a motor vehicle?*
-- No answer -- Yes No
Has any license or privelege ever been suspended or revoked?*
-- No answer -- Yes No
Work Availability*
-- No answer -- Full time Part time
Have you had any military service in the USA?
-- No answer -- Yes No
Do you have any relatives or friends employed by this company?
Have you ever incurred an occupational injury or condition?
NYS Department of Education requires a physical performance test be performed before hire and every 2 years. Components of the test require you have the ability to drag 125lbs, 30 feet, in 30 seconds and be able to evacuate a bus in 20 seconds.
Have you ever had any physical condition etc?
-- No answer -- Yes No
If yes, then explain.
Are you now covered by a medical plan?
-- No answer -- Yes No
If yes, list insurance provider and if whether a single or family plan.
Are you in active reserve?
-- No answer -- Yes No
Are you in National Guard?
-- No answer -- Yes No
Note: If you are NOT submitting a resume with this application, please answer the following questions. List 10 Years of verifiable employment experience:
Reason for leaving most recent job:*
-- No answer -- Undesirable Commute Retirement Better wages Better benefits Better work environment Better position COVID-19 Lay-off/ Downsizing Terminated Other
References: Provide 3 Personal References with Name & Contact Number (No Family Members)*
Invitation for Job Applicants to Self-Identify as a U.S. Veteran
A “disabled veteran” is one of the following:
a veteran of the U.S. military, ground, naval or air service who is entitled to compensation (or who but for the receipt of military retired pay would be entitled to compensation) under laws administered by the Secretary of Veterans Affairs; or
a person who was discharged or released from active duty because of a service-connected disability.
A “recently separated veteran” means any veteran during the three-year period beginning on the date of such veteran's discharge or release from active duty in the U.S. military, ground, naval, or air service.
An “active duty wartime or campaign badge veteran” means a veteran who served on active duty in the U.S. military, ground, naval or air service during a war, or in a campaign or expedition for which a campaign badge has been authorized under the laws administered by the Department of Defense.
An “Armed forces service medal veteran” means a veteran who, while serving on active duty in the U.S. military, ground, naval or air service, participated in a United States military operation for which an Armed Forces service medal was awarded pursuant to Executive Order 12985.
Voluntary Self-Identification of Disability
Voluntary Self-Identification of Disability Form CC-305
Why are you being asked to complete this form?
How do you know if you have a disability?
