Application LS

APPLICATION FOR  EMPLOYMENT

An Equal  Opportunity  Employer

We  do  not discriminate  on  the  basis  of  race,  color,   religion,  national  origin,   sex,  age,  disability,  or  any  other status  protected  by law  or regulation.  It  is  our intention  that all qualified  applicants  be given equal  opportunity and  that  selection  decisions  be based on job-related  factors.

Answer  each question  fully and  accurately.  No action  can  be taken  on this  application  until  you  have  answered  all  questions. In  reading  and  answering  the  following  questions,  be aware  that  none  of  the  questions  are intended  to imply  illegal preferences  or discrimination  based upon  non-job-related  information.

Full-timePart-timeTemporary

YesNo

(If you are hired, you may be required to submit proof of age.)

YesNo

YesNo

YesNo

YesNo

(A conviction will not necessarily disqualify an applicant for employment.)

YesNo

YesNo

YesNo

If you are offered but pending employment with LS Traffic Control in the interest of safety for all concerned, you will be required to take a urine test for drug and/or alcohol use,

have been fully informed of the reason for this urine test for drug and/or alcohol It understand what I am being tested for), the procedure involved, and do hereby freely give my consent. In addition, I understand that the results of this test will be forwarded to my potential employer and become part of my record.

If this test is positive, and for this reason I am not hired, I understand that l will be given the opportunity explain the results of this test. I hereby authorize these test results to be released to: LS Traffic Control