Physical Plant Bus Driver Application
DEMOGRAPHIC DATA SOCIAL SECURITY NUMBER APPLICATION DATE LAST NAME FIRST NAME M.I. Jr.Sr.etc.
CURRENT ADDRESS P.O. BOX STREET NUMBER STREET NAME APT. NUMBER CITY STATE ZIP CODE
ADDRESS P.O. BOX STREET NUMBER STREET NAME APT. NUMBER CITY STATE ZIP CODE HOME PHONE NUMBER WORK PHONE NUMBER CELL PHONE NUMBER
An Equal Opportunity Employer
BIRTHDATE NAME OF PERSON WHO IS IN PERMANENT CONTACT WITH YOU HOME PHONE NUMBER WORK PHONE NUMBER CELL PHONE NUMBER
WORK EXPERIENCE From MoYr To MoYr FT PT Employer & Email Mailing Address Phone Number Position Title Reason For Leaving Other experience if any which would qualify you for employment
Hatch Valley Public Schools P.O. Box 790 Hatch NM 87937 - 219 E Hill St. Hatch NM 87937 EMAIL ADDRESS
This application and the statements made herein become the property of the Hatch Valley Public Schools at the time the application is submitted. I swear under the penalty of perjury that the foregoing statements and all things related thereto are true and correct. I further acknowledge that by the making of a false statement. The furnishing of false information or the withholding of pertinent information in connection with this application will constitute grounds for dismissal. I understand that the Hatch Valley Public Schools will obtain an FBI Fingerprint background history upon employment and I here by authorize the release of information and further release from liability any and all parties who may supply personal information concerning my employment.
EDUCATION TRAINING Graduation or GED From MoYr To MoYr High School Location Colleges Degree or Semester Hours Check last year completed High School 10 11 12 GED College Describe any other training or education
EMPLOYMENT REFERENCES List previous supervisors. If inexperienced list names of department heads or teachers. Also include addresses and phone numbers.
Full Name of Reference Position Title of Reference Complete Mailing Address Phone Number Name Listed on Your Record
Have you ever been released or asked to resign from a position If yes explain
Can you furnish your own transportation for the job
VERIFICATION Signature of Applicant Date
Hatch Valley Public School has a no smoking no tobacco policy. Is your New Mexico Drivers License valid Have you ever been convicted of a felony
BUS DRIVER REQUIREMENTS Current Drivers License Class State Current First Aid Card Defensive Drving Card
Have you had any vehicle accidents or been arrested for a moving violation in the past 3 years Has your drivers license been suspended or revoked in the last 3 years Do you have any physical impairments that could interfere with the duties of a school bus operator
NEW MEXICO REGULATIONS PROHIBITS THE EMPLOYMENT OF PERSONS CONVICTED OF CRIMES OF VIOLENCE CRIMES INVOLVING MOTOR VEHICLES DWI SEX OFFENSES & MANSLAUGHTER INVOLVING A MOTOR VEHICLE. AS A CONDITION OF EMPLOYMENT THIS OFFICE MUST CONDUCT A CRIMINAL RECORD AND DRIVING RECORD CHECK. ALL INFORMATION WILL BE KEPT STRICTLY CONFIDENTIAL.