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As part of our normal procedure for processing applications, inquiries may be made concerning information on an applicant's work, driving, criminal and educational history.

A pre-employment drug screening and physical examination, to include range of motion tests, are conditions of employment. These tests must be successfully completed prior to starting work.

In compliance with applicable laws, this company does not discriminate because of age, gender, race, color, religion, marital status, national origin, handicap, sexual orientation or Vietnam era/disabled veteran status.
General Information
Name*
First Middle Last
Present Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Previous Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone*
Work Phone
Drivers License Number
Drivers License Expiration Date
State of Issue
Drivers License Type
Are you prevented from becoming lawfully employed in the U.S. because of your VISA or immigration status?*
- Yes
- No
Are you physically able to perform the essential function sof the job you are applying for?*
- Yes
- No
What accommodations could CityLink make which would enable you to perform the job functions properly and safely?*
Have you ever served in the U.S. Armed Forces?*
- Yes
- No
Length of Military Service*
Start Date End Date

Emergency Contact*

Name of Emergency Contact	Phone Number (including area code)

Career Information
Position Applying For?*
Minimum Salary Requirement*
Who referred you to our company?*
Have you ever worked for this company before?*
- Yes
- No

What position?*

Position Title	Dates of Employment

Have you ever applied for this company before?*
- Yes
- No

What position did you apply for?*

Position Title	Dates of Employment

Date available if your application for employment is accepted?*

Work & School History
All employment should be covered below including jobs held while in school or in the military. Record your present or last position.

Previous Employers - Please click the +button to add all previous employment*

Name of Employer	Address	Dates Employed	Position Held	Explain Duties and Responsibilities	Why did you Leave?	Name, Title, Phone of Supervisor

Previous Schooling - Please click the + button to add all education information*

Name of School/College	Address	Number of Years Completed	Grade Average	Did you Graduate?	Degree and Major?

List any other training you have had:
Extracurricular activities and offices held:
Academic honors or other special recognition:

History
Be sure to complete all questions on each job. Please explain all periods of unemployment.
Are you applying for a shop position?*
- Yes
- No
Are you applying for a clerical position?*
- Yes
- No
Special Skills
Please list the amount of experience you have in the following
Engine Tune-Up Diesel*
Years Months
Engine Tune-Up Gas*
Years Months
Vehicle Electrical Systems*
Years Months
Clutch and Transmission-Repair Trucks*
Years Months
Engine Rebuilding-Diesel*
Years Months
Body Work*
Years Months
Brakes and Steering*
Years Months
Lubrication*
Years Months
Vehicle Air Conditioning Repair*
Years Months
Transmission Rebuilding*
Years Months
Suspension Rebuilding*
Years Months
Accounting*
Length of Time Type
Billing*
Length of Time Type
Claims*
Length of Time Type
CRT*
Length of Time Type
Computer*
Length of Time Type
Word Processing*
Length of Time Type
Calculator*
Length of Time Type
Adding Mach.*
Length of Time Type
Shorthand*
Length of Time Speed WPM
Typing*
Length of Time Speed WPM
Excel*
Length of Time Type
Access*
Length of Time Type

Activities
Current Membership in Civic, Professional, Social or Other Organizations:
Past Membership in Civic, Professional, Social or Other Organizations:
Sports, Hobbies and other interests
Summary of Qualifications
This space is provided for you to briefly summarize any additional qualifications you feel are important in considering your application or employment. Include here any schools, certifications or seminars that you have attended that may pertain to the position you are applying for.
Applicant's Statement*
- I certify that I have read, understand, and agree to the above statements.
I certify that all statements made on this Application for Employment and in any subsequently executed medical questionnaire or any other employment documents are true and correct. I understand that any false information that I give may result in termination of my candidacy or any subsequent employment.

If an employee relationship is established, I understand that such employment is terminable at will, by either myself or CityLink and/or its affiliates (the Company), at any time, f or any r eason, with or without cause, and with or without notice. I also understand that any period of employment is not for a specific duration. In addition, I understand that no one is authorized to make oral exceptions to this policy, and written exceptions are permitted only when they are signed by the General Manager of CityLink.

I understand that CityLink is committed to establishing and maintaining a workplace free of discrimination. We are fully committed to equal employment opportunity. We will not tolerate unlawful discrimination in the recruitment, hiring, termination, promotion, salary treatment or any other condition of employment of career development. Furthermore, we will not tolerate the use of discriminatory slurs, other remarks, jokes, or conduct, that in the judgment of CityLink, encourage or permit an offensive or hostile work environment.

I understand that the Fair Credit Reporting Act, Public Law 91-508, requires that I be advised that routine inquiry may be made during the Company’s initial or subsequent processing which will provide applicable information concerning character and general reputation. I also understand that upon written request, additional information as to the nature and scope of the inquiry, if one is made, will be provided to me. I also understand that I am entitled to a free copy of the written report generated by the inquiry, if one is made.

I authorize the Company and its representatives to inquire of all former employers or others who know me or know of me. It is agreed and understood that the Company and its agents may conduct background evaluations including, but not limited to, criminal history checks from Federal, State or local authorities to ascertain any and all information of concern, whether same is of record or not, and I hereby expressly authorize such inquiries and release all employers and persons named herein from all liability for any damages on account of their furnishing such information.

I authorize the Company and its representatives to inquire of all former employers or others who know me or know of me. It is agreed and understood that the Company and its agents may obtain information including, but not limited to, Department of Transportation (DOT) mandated Pre-employment, refusals to test, alcohol tests of >.04, other violations of the DOT alcohol and drug rules, and return to duty and follow-up testing compliance, as applicable, and I hereby expressly authorize such inquiries and release all employers and persons named herein from all liability for any damages on account of their furnishing such information I acknowledge that any offer of employment is conditioned upon my taking a drug screen and the Company’ s receipt of satisfactory results of such a test and, if necessary to determine ability to perform essential duties of the position offered, the results of a physical examination.

Step 1 of 6

General Information

Career Information

Work & School History

History

Special Skills

Activities

Summary of Qualifications

Candidate Agreement