MICHIGAN TRANSPORTATION SERVICES
online application for employment

Last Name : Middle Name : First Name :

Address :

City :           State : Zip :

Telephone : email :

Are you 21 years of age or older?	Yes	No
Do you have a chauffeur's license?	Yes	No
Are you an honorably discharged veteran of the United States?	Yes	No
Are you legally authorized to work in the U.S.A.?	Yes	No
Have you ever been convicted of a crime?	Yes	No
Are there any current charges pending against you?	Yes	No

If yes, please explain :

High School Attended :	Degree Obtained :
College Attended  :	Degree Obtained :

Last Employer

Position Held

Address	City	State
Telephone	Supervisor
Start Date	End Date	Final Salary

Duties

Reasons for leaving position :

By submitting this application, you agree that all answers onthis document are true to the best of your knowledge. You understand that Michigan Transportation Services will rely on the above information in engaging and continuing your employment.

You also understand that this information may be verified by Michigan Transportation Services and that any misrepresentation of facts may constitute cause for dismissal.