Do you possess a current ____Yes ____ No driver’s license: Do you possess a current Yes _____ No commercial driver’s license: _____ Please list any endorsements: _____________________________________________________________ If you are under eighteen years of age, can you provide proof of eligibility to work: ___ Yes ___No Are you legally eligible to work in the : ____Yes ____ No Pursuant to Federal Law, proof of US Citizenship or immigration status will be required if you are hired. The (local unit type) is an Equal Opportunity Employer M/F Employment History: This section must be completed even if you attach a resume. List your last employers, major assignments within the same employer. Begin with the most recent. Include any military service. Explain any gaps in employment in the space on this form marked comments located on the bottom of this page. Employer: Date started: Date left: Work performed/ responsibilities: Address: Starting Salary: Job Title: Final Salary: Reason for leaving: name and phone number: Supervisor’s May we contact for a reference: ___Yes ___No Employer: Date started: Date left: Work performed/ responsibilities: Address: Starting Salary: Job Title: Final Salary: Reason for leaving: name and phone number: Supervisor’s May we contact for a reference: ___Yes ___No Employer: Date started: Date left: Work performed/ responsibilities: Address: Starting Salary: Job Title: Final Salary: Reason for leaving: name and phone number: Supervisor’s May we contact for a reference: ___Yes ___No
Do you possess a current driver’s license: ____Yes ____ No Do you possess a current commercial driver’s license: _____ Yes _____ No Please list any endorsements: _____________________________________________________________ If you are under eighteen years of age, can you provide proof of eligibility to work: ___ Yes ___No Are you legally eligible to work in the : ____Yes ____ No Pursuant to Federal Law, proof of US Citizenship or immigration status will be required if you are hired. The (local unit type) is an Equal Opportunity Employer M/F Employment History: This section must be completed even if you attach a resume. List your last employers, major assignments within the same employer. Begin with the most recent. Include any military service. Explain any gaps in employment in the space on this form marked comments located on the bottom of this page. Employer: Address: Date started: Date left: Work performed/ responsibilities: Starting Salary: Final Salary: Job Title: Reason for leaving: Supervisor’s name and phone number: May we contact for a reference: ___Yes ___No Employer: Address: Date started: Date left: Work performed/ responsibilities: Starting Salary: Final Salary: Job Title: Reason for leaving: Supervisor’s name and phone number: May we contact for a reference: ___Yes ___No Employer: Address: Date started: Date left: Work performed/ responsibilities: Starting Salary: Final Salary: Job Title: Reason for leaving: Supervisor’s name and phone number: May we contact for a reference: ___Yes ___No
Exhibit-C-Same-as-Exhibit-B-with-Track-Changes-Tool.docx