DRIVER APPLICATION FOR EMPLOYMENT

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PERSONAL INFORMATION

DRIVER'S LICENSE INFORMATION

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Please attach a copy of your valid CDL and a copy of your DOT Physical exam documentation.


Please list 2 references who can verify the quality of your driving abilities.
 NameCellphone NumberOrganizationRelationship
1)
2)

EDUCATION

Post-Secondary (Start from the most recent.)
 SchoolDegreeMajorYear
1)
2)
3)

AVAILABILITY

Please check the box for the time of the day you are available to drive. *
 7:00 am - 9:00 am4:00 pm - 6:00 pm2:30 pm - 4:00 pm6:15 pm - 8:15 pm
Monday
Tuesday
Wednesday
Thursday
Friday

WORK AUTHORIZATION

Only US citizens and aliens with legal documents to work in the United States are eligible for employment. If you are not a US citizen, Sipnayan Math Center and Afterschool program will require a copy of your Employment Authorization Document (EAD), Permanent Resident Card (green card), or any other visa that authorizes you to work with ANY US employer.

BACKGROUND CHECK

IMPORTANT! It is a 21st CCLC program requirement that all employees, service contractors and volunteers who work with the program have approved criminal background check. The center will run the following background check before hiring:

  1. NC Sex Offender Database and National Sex Offender Database
  2. Statewide Criminal Background Check including all states in which the employee or volunteer lives or has lived for the previous five (5) years.

Please note that individuals convicted of any kind of felony and/or any offense involving sexual or physical abuse/neglect against a child are strictly prohibited from working with the 21st CCLC Program.

Please type your initial across each statement.
 Initial
1) I authorize Sipnayan Math Center and Afterschool Program LLC to conduct an investigation of my background using the NC Sex Offender Database and the National Sex Offender Database.
2) I authorize Sipnayan Math Center and Afterschool Program LLC to conduct a national criminal background check to include all states in which I live or have lived in the past 5 years.
3) I understand that if I was found convicted of any kind of felony and/or any offense involving sexual or physical abuse/neglect against a child, I will not be eligible to work with the 21st CCLC Program run by Sipnayan Math Center and Afterschool Program LLC.
4) I understand that my social security number is necessary to run an accurate criminal background check. For the security of my personal information, I understand that this information will not be collected online. Therefore, I agree to provide my Social Security number via phone to Sipnayan's HR representative.
List all other names that were used previously. Please use one box for each former name.
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List ALL addresses in the last 5 years starting on the current address.
 StreetCityStateFrom-To (Year)
1)
2)
3)
Applicant Signature *
clear

Thank you for completing the application. We will let you know of the next steps in the process once your application is reviewed. Thanks!