The Niagara Falls Bridge Commission

EMPLOYMENT

US Application

Name:
Address:
City/State/Zip:
Phone:
In Emergency:
Social Security Num:
Yes	No
		Are you over the age of 18?
		Are you legally entitled to work in the United States?
		Do you possess a valid Social Security Card?
		Have you ever been employed with our company before?
		Have you ever been convicted of a criminal offense? **
		** If yes above, please give details:

Position applied for:	Toll Maintenance Administration
Type of Employment:	Full-Time Part-Time Seasonal
When will you be available for work?
Will you be returning to school?	Yes No
If returning to school please state dates:

Educational Background
(Check the highest level completed)
Secondary	9 10 11 12
College	1 2 3 4

Occupational Skills
Current New York State Drivers License Class A B CDLC NON-CDLC D DJ E M MJ
(Check the skills of which you have working knowledge)
	Equipment/Vehicle Operation
	Computer
	Computer Programs
	Office Equipment
	Trades (Please describe)
	Other (Please describe)

Present/Previous Employment
1.	Company Name:
	Phone:
	Address:
	City/State/Zip:
	Position:
	Employed from:	to:
	Reason for Leaving:
	Last Wage:
2.	Company Name:
	Phone:
	Address:
	City/State/Zip:
	Position:
	Employed from:	to:
	Reason for Leaving:
	Last Wage:
3.	Company Name:
	Phone:
	Address:
	City/State/Zip:
	Position:
	Employed from:	to:
	Reason for Leaving:
	Last Wage:
Do you give authorization to the Niagara Falls Bridge Commission to verify and receive comments on your employment records?
	Present Employer Previous Employers

Personal References
Other than family members or previous employers
1.	Name:
	Phone:
	Address:
	City/State/Zip:
2.	Name:
	Phone:
	Address:
	City/State/Zip:
3.	Name:
	Phone:
	Address:
	City/State/Zip:

(Please review the terms before submitting.)

I have read and agree to the Employment Application Terms
I disagree

Spanning The Future