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SafeRide Driver Application
SafeRide America is currently accepting creative and hard working applicants to fill a number of available positions.
To ensure proper consideration, please fill in the information below as completely and accurately as possible.
Personal Information
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First Name
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Last Name
Middle Initial
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Address 1
Address 2
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City
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State
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Postal Code
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Home Phone
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Cell Phone
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Email Address
Social Security Number (No dashes or spaces)
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Position Applying For
Intern
Chase Car Driver
Lead Driver
Dispatch
Sponsorship Enrollment
Volunteer Coordinator
Executive Director's Assistant
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Are you legally authorized to work in the United States?
Yes
No
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Do you have a valid drivers license?
Yes
No
Yes, from the state of
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What is your drivers license number?
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How many points do you have on your Motor Vehicle Report (MVR)
Unsure
0
1
2
3
4 or more
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Have you ever been convicted of a felony?
Yes
No
If yes, please explain.
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Have you ever been convicted of a DUI/DWI/OWI?
Yes
No
If yes, please explain.
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Which city are you applying to work in?
Atlanta
Macon
Tampa Bay Area
Orlando
Miami/Ft. Lauderdale
Other
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How long have you lived in the area that you are appling to work in?
I do not live in the Atlanta Area but plan to move there
I just moved here
Less than one year
1-2 years
3-5 years
5-10 years
More than 10 years
Availability
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Are you currently employed?
Yes, full time
Yes, part time
No
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Would you like to work with us full time or part time?
Full time
Part time
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Days Available
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Employment History
If you attach your resume below you can skip the Employment History Section. If not fill out everything ins this ssection as completly and accuratly as possible. We do verify past employment.
Employer
Address
Phone
From (MM/YYYY)
To (MM/YYYY)
Position
Salary
Supervisor/Manager
Reason for Leaving
Employer
Address
Phone
From (MM/YYYY)
To (MM/YYYY)
Position
Salary
Supervisor/Manager
Reason for Leaving
Employer
Address
Phone
From (MM/YYYY)
To (MM/YYYY)
Position
Salary
Supervisor/Manager
Reason for Leaving
References
Name
Title
Phone
Email Address
Name
Title
Phone
Email Address
Name
Title
Phone
Email Address
Additional Skills
List any additional skills that you would like to mention.
Available Work Tools
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Do you have your own car?
Yes
No
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What is the year of the car?
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
More than 10 years old
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What make is the car?
Acura
Audi
BMW
Buick
Cadillac
Chevrolet
Chrysler
Dodge
Eagle
Ford
GMC
Honda
Hummer
Hyundai
Infiniti
Isuzu
Jaguar
Jeep
Kia
Land Rover
Lexus
Lincoln
Mazda
Mercedes-Benz
Mercury
Mitsubishi
Nissan
Oldsmobile
Peugeot
Pontiac
Regal (Buick)
Saab
Saturn
Subaru
Suzuki
Toyota
Volkswagen of America, Inc.
Volvo of North America
Not listed
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What model is the car?
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Do you have full coverage or general liability?
Unsure
Full coverage
General Liability
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Enter your license plate number
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Do you have Global Positioning System (GPS)?
Yes, in came with my car
Yes, I have portable GPS
No, but I am willing to purchase one
No
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Do you own a cell phone?
Yes
No, but I am willing to get one
No
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Who is your cell phone service through?
AT&T/Cingular
Verizon
Sprint/Nextel
T-mobile
Metro PCS
Boost
Virgin
Tracfone
STI
NET10
Not Listed
Unsure
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Do you have free nights and weekends?
Unsure
Yes
No, but I am willing to add it to my plan
No
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Do you have a car charger for your phone?
Yes
No, but I am willing to get one
No
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Can you send and recieve text messages?
Unsure
Yes, unlimited
Yes, limited
No, but I am willing to add it to my plan
No
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Can you send and recieve email with your cell phone?
Unsure
Yes
No
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Can you access the internet with your phone?
Unsure
Yes, unlimited
Yes, limited
No, but I am willing to add it to my plan
No
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Do you have a computer at home?
Yes
No, but I am willing to get one
No
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Do you have a printer for the computer?
Yes
No, but I am willing to get one
No
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Do you have an internet connection for your computer?
Yes
No, but I am willing to get one
No
What type of internet connection do you have?
Unsure
Dial-up
Basic DSL
High speed DSL
Cable
Satellite
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How familiar are you with the following
Very
Somewhat
Not at all
Google Search
Gmail
Google Calender
Google Docs
Use this space to make any comment or ask any question about the job or about SafeRide America
Please feel free to submit a copy of your resume if you have one.
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Indicates Response Required