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APPLICATION FOR EMPLOYMENT

J.A. Miara Transportation, Inc. is an equal opportunity employer committed to making employment decisions on a nondiscriminatory basis. Consequently, if you require any accommodations in order to apply or be fairly considered for a position, please let us know.

Please fill out the form below or click here to download an application.

Provide only information which is requested. The provision of nonresponsive information will result in disqualification of this application.


*Required Fields

*Last Name:   
*First Name:   
Middle Initial:   
Address (Number & Street):   
Address (cont.):   
City:   
State/Province:   
Zip/Postal Code:   
*Phone:   
Email:   
Position Desired:   
Social Security Number:   
*Are you under 18 years of age?:   
How were you referred?:   
Date able to start:
Are you able to work all shifts?:
In NO, when are you UNABLE to work?:
*Are you a U.S. Citizen or authorized to work legally in the United States?
Cities/States of residence the past 7 years:
   
DRIVING HISTORY  
Do you have a valid driver's license?
Driver's license number:
State:
Class of license:
Has your driver's license been suspended or revoked in the last 3 years?:
If YES, give details:
How many motor vehicle accidents have you had in the past 5 years?:
   
MILITARY SERVICE  
Branch:
Rank:
Discharge date:
Training or type of work done in miitary service:
What machines or equipment can you operate that are related to the job for which you are applying?:
   
EDUCATION & TRAINING Please list all schools you attended from High School to present. Include trade and technical schools and any courses which may be relevant to your application.
Name of High School:
City & State:
Course Degree:
Dates Attended:
Name of Trade/Technical School:
City & State:
Course Degree:
Dates Attended:
Name of College:
City & State:
Course Degree:
Dates Attended:
Other Courses/Schooling (include apprenticeship):
City & State:
Course Degree:
Dates Attended:
Professional or Technical licenses (for each, list state and date):
Please describe any job-related skills or training not mentioned above:
Have you ever been fired from a job or asked to resign?:
   
WORK HISTORY List employers in order with present employer first. Account for all periods of time. If self-employed, give firm name and business references. Work performed on a volunteer basis may be included.
Employer 1:
Address:
Start Date:
Leave Date:
Wage:
Job title:
May we contact your supervisor?:
Supervisor:
Phone:
Description of work:
Reason for leaving:
Employer 2:
Address:
Start Date:
Leave Date:
Wage:
Job title:
May we contact your supervisor?:
Supervisor:
Phone:
Description of work:
Reason for leaving:
Employer 3:
Address:
Start Date:
Leave Date:
Wage:
Job title:
May we contact your supervisor?:
Supervisor:
Phone:
Description of work:
Reason for leaving:
Employer 4:
Address:
Start Date:
Leave Date:
Wage:
Job title:
May we contact your supervisor?:
Supervisor:
Phone:
Description of work:
Reason for leaving:
Employer 5:
Address:
Start Date:
Leave Date:
Wage:
Job title:
May we contact your supervisor?:
Supervisor:
Phone:
Description of work:
Reason for leaving:
Are you on a layoff and subject to recall?:
Are you known to schools/references (prior employers) by another name? (information sought solely to facilitate reference checks):
If YES, what name?:
   
REFERENCES Provide names of three persons not related to you, whom you have known at least one year.
Name:
Address:
Business:
Years acquainted:
Name:
Address:
Business:
Years acquainted:
Name:
Address:
Business:
Years acquainted:
   
CONVICTION INFORMATION An applicant with a sealed record of entries on file with the commissioner of probation may answer "no record" to an inquiry about prior convictions of a crime. In addition, any applicant for employment may answer "no record" to an inquiry relative to all cases of delinquency or as a "child-in-need-of-services" for which no criminal prosecution resulted.
Have you ever been convicted of a felony?:
If YES, explain:
Have you been convicted of a misdemeanor within the past 5 years? (Do not include a first conviction for drunkeness, simple assault, speeding, minor traffic violations, affray or disturbances of the peace.):
If YES, explain:
   
 

I certify that the information given above is true and complete and understand that misinterpretation and/or omission of requested information will result in the rejection of this application or my discharge if discovered after employment begins. I authorize J.A. Miara Transportation, Inc. to make inquiries regarding my history and character of prior employers, schools, government agencies or individuals and hereby release such entities and individuals from all liability with respect to such inquiries.

If I am applying for a position as a driver or other safety sensitive position, I understand and agree that I may be required to take physical examinations and drug tests as a condition of employment and continuation of employment and I agree to take such tests and to release J.A. Miara Transportation, Inc., its such owners, officers, agents and employees from any claim arising in the use of such tests.

I understand that if employed, I will be an employee “at will” and may be terminated at any time, with or without cause, and with or without notice at the option of either J.A. Miara Transportation, Inc. or myself. If I am employed, I agree to abide by J.A. Miara Transportation, Inc. policies, rules and procedures and any changes thereto. I further understand that no J.A. Miara Transportation, Inc. representative other than the J.A. Miara Transportation, Inc. President, and then only in writing and signed by the President has authority to enter into any agreement for employment for any specific period of time or to make agreement contrary to the foregoing.

*Do you agree to the statement above?:
Date:
   
DISCLOSURE TO APPLICANT OR EMPLOYEE REGARDING PROCUREMENT OF A CONSUMER REPORT This is to advise you that as a part of our employment screening process, and investigation of your background will be conducted. The investigation will be in the form of a consumer report or investigative consumer report. The reports are for the purpose of evaluating you for employment, promotion, reassignment or retention as an employee.

In the event that information from the report is utilized in whole or part in making an adverse decision with regard to employment, before making the adverse decision we will provide you with a copy of the consumer report and a written description of your rights under the Federal Credit Reporting Act. You may also have the right to request additional disclosures regarding the nature and scope of the investigation.

Please enter your full name as an electronic signature to hereby authorize us to obtain a consumer report about you in order to consider you for employment, reassignment or retention.

*Please Type Full Name:   
Electronic Signature
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140 West Street • Wilmington MA 01887 • p: 978-658-3616 • f: 978-658-4038 • Sales@jamiara.com

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