Employment Application Form - Maryland Transit Administration
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4EMPLOYMENT APPLICATION
Maryland Transit Administration
Today’s Date: ___/___/___
William Donald Schaefer Tower
(mm dd yy)
th
6 Saint Paul Street, 5
Floor
Baltimore, Maryland 21202-1614
FOR HUMAN RESOURCE DEPARTMENT USE ONLY – DO NOT WRITE IN THIS SPACE
(Circle One)
Certified
Not Certified-Reason Code: ____________
Reviewed by Initials/Date: __________/_________
Date Entered in SIGMA: Initials/Date:_______/_______
INSTRUCTIONS TO APPLICANT::
Please PRINT and FILL OUT completely. Illegible information or omissions may result in an application being rejected. False, erroneous, or misleading
answers or statements may be cause for rejection of application or discharge from MTA service. Resumes cannot be substituted in place of this application.
(NOTE: If more space is required to present additional information for any section below, please attach.)
Position Applied for:
__________________________________________________________________ Social Security No. ______ - ____ - _______
(A separate application is required for each classification or position for which application is filed.)
Applicant’s Name:
_______________________________________________________________________________________________________
Last Name
First Name
Middle Name
Address:
________________________________________________________________________________________________________
Number and Street or R.F.D.
________________________________________________________________________________________________________
City
State
Zip Code
Home Phone: (
) ______ -___________
Work Phone: (
) ______ -___________
Cell Phone: (
) _____ -___________
Email Address: ________________________________ Other Names Used: (i.e., Maiden Name, etc.) _______________________________________
A. EDUCATION, SKILLS AND QUALIFICATIONS
High School or GED Education
1.
:
Did you graduate from high school or have you obtained a GED? (Circle One) YES
NO
If YES, provide the following information:
High School’s Name: _____________________________________________________________________________________________
High School’s Address: ____________________________________________________________________________________________
Year of Graduation or Received GED: _____________ If you answered NO, circle the highest grade completed:
8
9
10
11 12
2.
College/University Education: List most recent college education below.
Name of College/University: ____________________________________________
Dates Attended: From _________ To __________
Address: ___________________________________________________________________________________________________________
Major: ___________________________________________________
Degree Title: _____________________________________________
Number of Credit Hours Completed: __________
Year Degree was Received: ____________
Training
3.
: List any trade and technical courses, or instruction you have completed.
Trade or Technical School’s
Completed?
Certificate Awarded
Name and Address
Course Title
(YES or NO)
Title
Date
_____________________________________________ __________________________
______
________________ ________
_____________________________________________ __________________________
______
________________ ________
Additional Skills and Qualifications
4.
: To help the MTA evaluate your qualifications for this position, please list any additional information (e.g.
special skills, computer skills and programs, licenses, etc.), and the level of proficiency (e.g. basic, intermediate or advanced).
_________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________
MJ45
Page 1 of 4
Revised 03/2013
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