Car Operations Clerk Job Application, The Belt Railway Company of Chicago

Contact Information & QuestionsStep 1 of 3

Contact Information

Date of Application *

First Name *

Middle Name *

Last Name *

Social Security Number

Optional: Can be provided in person

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Zip / Postal Code

Country

Phone (primary) *

Phone (secondary)

Email *

Confirm Email

Driver's License No. *

Questions

Are you available to work any shift? *

Are you able to work on call (i.e., without a set shift)? *

Are you able to work outdoors in all types of weather conditions? *

Can you perform the functions of the job you are applying for (as set forth in the job description) with or without reasonable accommodation? *

Do you use illegal drugs? *

Have you ever worked for the Belt Railway Company? *

Have you ever worked for another railroad company? *

If yes, please list railroad, dates of services, and current status:

Have you had any military service? *

If yes, please list branch of service, dates of service, and current status

Have you ever been discharged by an employer? *

If yes, please explain circumstances leading to your discharge

Education

Please list: Name of school, City, State, Degree or diploma, Number of years attended and Graduation Year.

College *

Business or Trade School *

High School *

Employment History

Please start with your most recent position. Complete all information below even if submitting a resume

JOB 1

Dates employed from start to finish:

Employer:

Address:

Address Line 1

Address Line 2

City

State / Province / Region

Zip / Postal Code

Country

Job Title:

Immediate Supervisor:

May we contact? *

Reason for Leaving:

Supervisor phone number:

JOB 2

Dates employed from start to finish:

Employer:

Address:

Address Line 1

Address Line 2

City

State / Province / Region

Zip / Postal Code

Country

Job Title:

Immediate Supervisor:

May we contact? *

Reason for Leaving:

Supervisor phone number:

JOB 3

Dates employed from start to finish:

Employer:

Address:

Address Line 1

Address Line 2

City

State / Province / Region

Zip / Postal Code

Country

Job Title:

Immediate Supervisor:

May we contact? *

Reason for Leaving:

Supervisor phone number:

JOB 4

Dates employed from start to finish:

Employer:

Address:

Address Line 1

Address Line 2

City

State / Province / Region

Zip / Postal Code

Country

Job Title:

Immediate Supervisor:

May we contact? *

Reason for Leaving:

Supervisor phone number:

Please list any special skills, certificates, training, etc. that may quality you to perform job-related function of the position for which you are applying:

References

Please list four professional references other than previous supervisors that you've listed above. Please list: Name, title, company, relationship and phone numbers.

Reference 1

Reference 2

Reference 3

Reference 4

Certifications *

Select All
I understand that in order to be considered for employment, I must submit to and successfully pass a post-offer, pre-employment drug screen
I understand that Direct Deposit of my earnings to the bank of my choice is a condition of employment.
I understand that if I am employed, any misrepresentation or material omission made by me on this application will be sufficient cause for cancellation of this application or immediate discharge from the employer's service, whenever it is discovered.
I give the employer the right to contact and obtain information from all referenced employers, educational institutions and to otherwise verify the accuracy of the information contained in this application. I hereby release from liability the employer and its representatives for seeking, gathering and using such information and all other persons, corporations or organizations for furnishing such information.
I agree to permit a post job offer, pre-employment physical examination of myself at such time and place and by such doctor or doctors as may be selected by the company. I agree on behalf of myself, my heirs and personal representatives that, in the event of any dispute or litigation in which my physical condition at any time shall be an issue, that any physician or surgeon may freely disclose, divulge or testify concerning such physical condition or concerning any communication made by me to said physician or surgeon and I expressly waive the benefit of any state or federal law whereunder information gained by any physician or surgeon respecting my physical condition is wholly or partially privileged.

Signature

I have read and fully understand the foregoing and seek employment under these conditions.

Date

Witness

Date

Full Name *

Position Applying For

Your answers are completely voluntary

Pursuant to federal regulations, we collect responses to the questions below for record keeping purposes. This information will NOT be kept with your application for employment. Federal law prohibits unlawful discrimination on the basis of race, color, sex, age, national origin, religion, or disability.

Check the racial or ethnic group with which you identify

Caucasian
African American
Hispanic: Puerto Rican, Central or South American or other Spanish origin or culture
American Indian Islanders
Two or more races

Check the appropriate

Female
Male

Check the block for Veterans Status group with which you might identify

Veteran
Vietnam Veteran
Diabled Veteran

Date of Birth

How did you find out about this employment opportunity?

Newspaper*
Radio/TV
Belt Railway Company Website
Internet Career Website*
RRB Job Website
Agency Bulletin Board
Other (please specify)

*Specify name of newspaper or job search website

Signature *

Date *

The Belt Railway Company of Chicago is an Equal Opportunity Employer

Phone