Careers - NEMT Driver Job Openings in Phoenix & Tucson, AZ - Handicap Accessible Vehicle Operator

Application for Employment

Thank you for your interest in joining the HealthLift team! Please complete the digital form below or print this application and email to Tamara@gohlaz.com.

If you have any questions please call (602) 298-1818.

Print Application

Name(Required)

First Middle Last

Email(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

How Long?(Required)

Social Security Number(Required)

Desired Position(Required)

Days Available To Work(Required)

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

Monday Available Time From

Monday Available Time To

Tuesday Available Time From

Tuesday Available Time To

Wednesday Available Time From

Wednesday Available Time To

Thursday Available Time From

Thursday Available Time To

Friday Available Time From

Friday Available Time To

Saturday Available Time From

Saturday Available Time To

Sunday Available Time From

Sunday Available Time To

Hours available to Work(Required)

Available to work nights(Required)

Date available to start(Required)

Employment type desired(Required)

Have you ever been part of a DOT Drug program?(Required)

High School(Required)

College(Required)

Trade/Prof. School(Required)

Have you ever been convicted of a crime, misdemeanor or felony?(Required)

If yes, please explain

Mode of Transportation to work:(Required)

Driver’s license number(Required)

Issuing State(Required)

Type(Required)

Expiration Date(Required)

How many accidents in the past 7 years?(Required)

How many moving violations in the past 7 years?(Required)

Emergency contact(Required)

Address of Emergency Contact:(Required)

Telephone of Emergency Contact:(Required)

List two (2) references other than relatives or previous employers.

First reference other than relatives or previous employers(Required)

First Last

First reference position(Required)

First reference company(Required)

First reference Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

First reference phone(Required)

Second reference name(Required)

First Last

Second reference position(Required)

Second reference address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Second reference phone(Required)

Please use the space below to add any additional information you would like to add regarding qualifications for the position you are applying for:(Required)

MILITARY SERVICE

HAVE YOU EVER BEEN IN THE ARMED SERVICES?(Required)

ARE YOU NOW A MEMBER OF THE NATIONAL GUARD?(Required)

Branch

Date Entered

Discharge Date

Please list your experience for the past two (2) years beginning with your most recent job.

Name Of Employer(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Reason for leaving(Required)

Name of last supervisor:(Required)

Your last job title:(Required)

Dates of Employment From:(Required)

Dates of Employment To:(Required)

First Salary(Required)

Final Salary(Required)

Job duties held, skills used or learned, advancements(Required)

Name Of Employer(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Reason for leaving(Required)

Name of last supervisor:(Required)

Your last job title:(Required)

Dates of Employment To:(Required)

Dates of Employment From:(Required)

First Salary(Required)

Final Salary(Required)

Job duties held, skills used or learned, advancements(Required)

Application Waiver

Consent(Required)

I agree to the privacy policy.

In exchange for the consideration of my job application by “Transportation Company” (hereinafter called “The Company”) I agree that:
Neither the acceptance of this application nor the subsequent entry into any type of employment relationship either In the position applied for or any other position and regardless of the contents of employee handbooks, personnel manuals, benefit plans, policy statements, and the like as they may exist from time to time, or other company practices shall serve to create an actual or implied contract of employment, or to confer any right to remain an employee of “The Company” or otherwise to change in any respect the employment-at-will relationship between it and the undersigned. That relationship cannot be altered except by a written instrument signed by the President/General Manager of the company. Both the undersigned and “The Company” may end the employment relationship at any time, without specified notice or reason. If employed, I understand that the company may unilaterally change or revise their benefits, policies, and procedures. Such changes may include a reduction in benefits.
I authorize investigation of all statements contained in this application. I understand that the misrepresentation or omission of facts called for, is cause for dismissal at any time without any previous notice. I hereby give “The Company” permission to contact schools, previous employers (unless otherwise indicated in this application), references, and others. I hereby release the company from any liability as a result of such contact.
I also understand that (1) the company has a drug and alcohol policy that provides for pre-employment testing as well as random testing after employment. (2) Consent to and compliance with such policy is a condition of my employment (3) continued employment is based on the successful passing of testing under such policy. I further understand that continued employment may be based on the successful passing of job-related physical examinations.
I understand that, in connection with the routine processing of your employment application, “The Company” may request from a consumer reporting agency in investigative consumer report including information as to my credit records, character, general reputation, personal characteristics, and mode of living. Upon written request from me, “The Company”, will provide me with additional information concerning the nature and scope of any such report requested by it, as required by the Fair Credit Reporting Act.
I further understand that my employment with the company shall be probationary for a period of ninety (90) days, and further that at any time during the probationary period or thereafter, my employment relation with the company is terminable at will for any reason by either party.

Date

This is an equal employment opportunity employer. We adhere to a policy of making employment decisions without regard to race, color, religion, sex, sexual orientation, national origin, citizenship, age, or disability. Opportunity for employment with his company solely depends on qualifications.

Signature