Mid America Car Inc.- Locomotive

Text Box: Mid-America Car, Inc.—Locomotive

MID-AMERICA CAR, INC.—LOCOMOTIVE APPLY ONLINE

Welcome to the Online Application for employment section of the website. Please complete the application in its entirety in order for your application to be processed correctly.

1. I certify that I have had the opportunity to read the applicant
instructions prior to filling out the application.
I also certify that I agree to the terms of the applicant instructions.

2. Today's Date
MM-DD-YYYY

3. Name
Last, First, Middle Initial

4. Social Security Number
NNN-NN-NNNN

5. Home Phone
NNN-NNN-NNNN

6. Work Phone
NNN-NNN-NNNN

7. Current Address
LINE 1: House Number & Street
LINE 2: City, State, Zip Code

8. Prior Address
LINE 1: House Number & Street
LINE 2: City, State, Zip Code

9. I certify that I have had the opportunity to
read the applicant note prior to filling out the application.
I also certify that I agree to the terms
of the applicant note.

10. E-Mail Address
user@host.com

11. For which positions are you applying for?
Select all that apply

Locomotive Mechanic
Supervisor
Repairer
Painter
Locomotive Electrician
General Clerk
Inventory Clerk

12. What date would you be available to start?
NN-NN-NNNN

13. What category of employment would you prefer?
select all that apply

Full-Time
Part-Time
Temporary
Laborpool

14. For which schedules are you available?
select all that apply

Weekdays
Weekends
Evenings
Nights
Overtime
Shift
Other - Note on comments

15. What was the highest grade that you completed?

16. High School Info.
LINE 1: Name of High School
LINE 2:City, State of high school
LINE 3: Date of initiation, date of termination
LINE 4: Did you graduate?

17.College Info:
LINE 1: Name of college
LINE 2:City, State of college
LINE 3: Date of initiation, date of termination
LINE 4: Did you graduate?
LINE 5: Degree you graduated with.

18.Other School Info:
LINE 1: Name of other school
LINE 2:City, State of other school
LINE 3: Date of initiation, date of termination
LINE 4: Did you graduate?
LINE 5: Degree you graduated with.

19. List states and counties of residence for the past seven years.

20. List any additional names or social security numbers that you
may have used other than those listed on this page.

21. List any felony convictions and time served in prison in the last seven years.
State the incident, city, state, and charge.
In accordance with company policy this information will be reviewed for job
relatedness and time since last conviction

22. Select languages that you are fluent in.

English
Spanish
French
Arabic
Other - Noted in comments

23. Please enter the following information about your driver's license.
LINE 1: If the job you are applying for requires a license, do you carry that license?
LINE 2: Driver's License Number
LINE 3: Type of driver's license
LINE 4:State of iss

24. Describe any moving violations you may have on your driver's license.

25. Please list any other skills, licenses, or certificates that may be job related
or that you feel would be of value to this job or company.

26. Have you had a chance to review the job descriptions or had therequirments of the job explained to you?

27. Do you understand these requirements?

28. Would you be able to perform these requirements with or without any reasonable accomodations?

29. Most Recent Employer:
LINE 1: Company Name
LINE 2: City/State
LINE 3: Phone
LINE 4: Dates employed
LINE 5: Job Title
LINE 6: Supervisor Name
LINE 7: Duties
LINE 8: Salary and terms
LINE 9: Reason for leaving

30. Are you currently working for this employer?

31. If yes, may we contact?

32.Second Most Recent Employer:
LINE 1: Company Name
LINE 2: City/State
LINE 3: Phone
LINE 4: Dates employed
LINE 5: Job Title
LINE 6: Supervisor Name
LINE 7: Duties
LINE 8: Salary and terms
LINE 9: Reason for leaving

33. Third Most Recent Employer:
LINE 1: Company Name
LINE 2: City/State
LINE 3: Phone
LINE 4: Dates employed
LINE 5: Job Title
LINE 6: Supervisor Name
LINE 7: Duties
LINE 8: Salary and terms
LINE 9: Reason for leaving

34. Please enter all of your information for your first reference.
LINE 1: Name of reference
LINE 2: Street Address
LINE 3: City, State, Zip code
LINE 4: Phone Number
LINE 5: Years Known
LINE 6: Relationship

35. Please enter all of your information for your first reference.
LINE 1: Name of reference
LINE 2: Street Address
LINE 3: City, State, Zip code
LINE 4: Phone Number
LINE 5: Years Known
LINE 6: Relationship

36. Comments

37. I agree to the conditions set forth in the certification & Release statement.

38. I agree to the terms in the Statement of social security number to be used as signature.

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