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Online Application for Employment

Submitted by matt on Mon, 07/30/2007 - 18:15.

Iowa Interstate Railroad, Ltd., (IAIS) is an Equal Opportunity Employer and does not discriminate on the basis of race, color, religion, national origin, age, sex, sexual orientation, marital or veteran status, medical condition or disability, or any other basis prohibited by applicable law.

Date of Application: May 10, 2008

PERSONAL INFORMATION

Name:*  

Last
First
Middle
Address:*  

Street
City
State
Zip Code
Telephone:*     Alt. Telephone:  
Email:*  
Are you 18 years of age or older:*   Yes   No
(If not, employment is subject to verification of minimum legal age requirement.)
Are you legally eligible for employment in the United States?*   Yes   No
(Note: If hired, you will be required to furnish proof of U.S. Citizenship or your authorization to work in the U.S. as specified under applicable U.S. Immigration laws.)

GENERAL INFORMATION

Position(s) applying for:*  
Full Time:     Part Time:
Was a job description included with this Application of Employment?   Yes   No
If yes, please identify the job title listed on the job description:  
If part-time, specify hours or days:  
Check location(s) interested in working at:*  
Iowa City   Newton   Council Bluffs   Cedar Rapids   Rock Island   Blue Island (Chicago)  
Check the following that you will work:*
Days   Saturdays   Nights   Sundays   Overtime   Relief or swing shift  
Willing to relocate?*   Yes   No
Can you travel if the job requires it?*   Yes   No
Date available to work:  
IAIS has a nepotism policy, therefore, do you have any relatives who work here?*   Yes   No
If yes, list name(s):  
List names of friends or persons you know who work here:  
Have you previously applied at IAIS?   Yes   No
If yes, where, when and what position(s)?  
Have you ever been employed by IAIS?*   Yes   No
If yes, give dates:  
Are you on furlough (laid-off) and subject to call?*   Yes   No
Dates subject to recall:  

EMPLOYMENT EXPERIENCE

List all job activities and other experience, including self-employment, volunteer work, part-time work while in school, and U.S. military service for the past 10 years. Also list significant experience prior to this period beginning with the most recent. Please attach additional sheet of employment experience, if necessary.
Employer (present or most recent):*  
Address:*

Street
City
State
Zip
Supervisor (name and title):*  

Name
Title
Area Code/Telephone No.:*  
Your job title:*  
Description of your duties:*  
From (month/year):*  / To (month/year): /
Rate of pay:* $ per
Reason for leaving:*  
May we contact you at your present place of employment?*   Yes   No
If yes, please enter your telephone number:  
Employer:  
Address:

Street
City
State
Zip
Supervisor (name and title):  

Name
Title
Area Code/Telephone No.:  
Your job title:  
Description of your duties:  
From (month/year):  / To (month/year): /
Rate of pay: $ per
Reason for leaving:  
Employer:  
Address:

Street
City
State
Zip
Supervisor (name and title):  

Name
Title
Area Code/Telephone No.:  
Your job title:  
Description of your duties:  
From (month/year):  / To (month/year): /
Rate of pay: $ per
Reason for leaving:  
Have you worked for any other railroad(s)?   Yes   No     If yes, complete the following:
RailroadStatePosition HeldServiceLeaving
We may contact the employers listed above unless you indicate those you do not want us to contact.
Do Not Contact Employer:  
Reason:  
Have you ever been involuntarily terminated from any previous position?*   Yes   No
If yes, please explain:  
List periods of unemployment of a month or more between schooling, military or employed periods during the past 10 years. Provide names and addresses of persons other than relatives who can verify.
From (month/year): To (month/year): Name: Address (City & State) & Telephone: 
/  /   
/  /   
/  /   
Other occupational skills (please check and indicate number of years):
Years   Years   Years
Adding machine   Conductor   CDL License  
CRT equipment   Brakeman/switchman   Heavy equip.oper.  
Calculator   Railroad dispatcher   Crane operator  
PC computer skills   Electrician   Painter  
Data entry   Machinist   Plumber  
Typing   Railroad car repair   Pipefitter  
Locomotive engineer   Truck driver   Carpenter  
Drafter/engineer  
State any additional work-related information you feel would be helpful to us in considering your application?
Is there anything that would prevent you from performing in a reasonable and safe manner the activities involved in the position for which you have applied?*   Yes   No
If yes, please explain?  
Have you ever been convicted of a crime?*   Yes   No
If yes, state offense, penalty and date of occurrence:  
A conviction itself does not constitute an automatic bar to employment and will be considered insofar as it relates to performing the job in question.

U.S. MILITARY SERVICE

Service branch:  
Initial rank:  
From (mo/yr):  /  To (mo/yr):  /
Final rank:  
Specialty:  
What type of training and/or education did you receive while in the military?  
Reserves:   Yes   No

EDUCATION

Select highest grade completed:*    

Name and Location of school/institution
(Name,City & State)		No. of years
attended		Degree/ Certificate ReceivedCourse of study
High School
College/University
Graduate School
Trade

REFERENCES

List a minimum of 2 persons, not related to you, whom are qualified to answer questions concerning past employment and/or educational experience.
Name*Company & Position*AddressArea Code/Telephone*

APPLICANT

READ STATEMENTS BELOW CAREFULLY BEFORE SUBMITTING THIS APPLICATION.
    I HEREBY CERTIFY:
  1. The answers I have given to the foregoing questions and statements are true and correct, without mental reservation of any kind; and I authorize Iowa Interstate Railroad, Ltd. (IAIS) to verify them.
  2. If I obtain employment from this Application, I agree to comply with all orders, rules and regulations of the Company and federal government.
  3. I acknowledge that this Application does not, by itself, create a contract of employment. I understand and acknowledge that if I am hired my employment can be terminated with or without cause and notice at any time, either by IAIS or me, except as otherwise provided by the terms of a union contract applicable to me.
  4. I acknowledge that I have signed the attached release authorizing IAIS to perform all checks of my credentials as allowed by law and obtain information or documentation that IAIS, in its sole discretion, believes may have relevant information regarding my suitability for employment. That whenever requested by IAIS, I will supply satisfactory, documentary evidence, in verification of any statement contained herein.
  5. That the position which I am offered may require a medical examination including drug-screening, x-rays, vision (including color), and hearing examinations, and I consent to the release to IAIS of any and all medical information, as deemed necessary, and that my offer of employment may be revoked should the medical examination indicate I am not able to perform the job consistent with State and Federal laws.
  6. I agree to immediately notify IAIS if I should be convicted of a felony, or any crime involving dishonesty or a breach of trust while my job application is pending, or during my period of employment, if hired.
  7. That I have read and understand all of the above and hereby warrant the information in this Application (and accompanying resume, if any) is true and complete. I understand that any false information or omissions may disqualify me from further consideration for employment, and may be justification for my dismissal from employment if discovered at a later date.
I have read and agree to these statements.*

IAIS maintains an active application file for one (1) year. If you wish to activate your application for any position during that time, please notify the Human Resources Office.

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