Official SealHillsborough County Government


#1906-PRTMOPCOS3-002
Supplemental Questionnaire

Last Name
First Name

 

Supplemental Questionnaire


INSTRUCTIONS: Completion of this supplemental questionnaire is REQUIRED. Please read each question carefully and provide clear and complete responses that accurately portray your education and relevant work experience. Your qualifications for employment will be evaluated based upon the information you provide in your responses below and then verified by our staff who will review your entire application for completeness and determine qualification status.

The employers and dates of employment that you list on this supplemental questionnaire MUST match the employers and dates of employment provided in the work experience section of your employment application. Failure to provide matching employer, and dates of employment may result in your application being "not qualified" for this recruitment.

IMPORTANT NOTE: "See Resume" is not an acceptable response to any of the open-ended questions on this questionnaire and will result in your application being "not qualified" for this recruitment.



 

Please select your highest completed level of education:

Bachelors Degree or higher
Associates Degree
Graduation from high school or possession of a G.E.D. certificate
I have not completed any of the educational requirements listed above
 

Select the option that indicates the number of years of experience you have in operating a minibus or van transporting passengers in a paratransit environment. (Years of experience are based on a FULL TIME work schedule; i.e. 40 or more hours per week)

Four or more years of experience
3 years of experience
2 years of experience
1 year of experience
Less than one year of experience
 

This position requires a valid Florida driver’s license prior to employment. If selected for this position, will you be able to meet this requirement? 

Yes No
 

Have you had any traffic violations (for example: reckless driving, speeding, leaving the scene of an accident, D.U.I., etc.) within the past 3years?

Yes No
 

Please provide a narrative explaining your experience operating a passenger vehicle (i.e. mini bus or passenger van) and transporting passengers for hire on a pre-scheduled route or for a nonprofit organization. Be sure to include the specific job title, organization and dates where the work was performed, and job duties:(IMPORTANT the employers and dates of employment that you list here must also be included in the “employment” section of this job application) (Years of experience are based on a FULL TIME work schedule; i.e. 40 or more hours per week):

 

Describe your experience working with and assisting the elderly and persons with disabilities? Please include what assistance was provided?

 

Are you able to perform work under extreme environmental and demanding physical conditions, able to push, pull and lift up to 55 pounds and maneuver a wheel chair up to 600 pounds?

Yes No
 

Are you able to work flexible hours that may vary based on operational needs which may include evenings, weekends, nights, and holidays to include responding to Emergency Operations Center requests to evacuate citizens in the event of an emergency?

Yes No
 

The starting salary for this position is $13.21 per hour. If selected, is this salary acceptable?

Yes No
 

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By checking the box above, I certify that all of my responses are true and complete, and any misstatement of material facts OR failure to completely answer questions or provide my employer with a copy of any licenses, certifications, or other documents listed on the job announcement will subject me to disqualification from the application process and/or dismissal from employment.

I also authorize investigation of all statements contained in my application, to include a formal background check that may require education and employment verification; criminal history; and motor vehicle driving report as may be necessary in arriving at an employment decision. Further, I acknowledge understanding that an offer of employment will be subject to successfully passing a drug screen and physical.

I also understand that once I submit my application for this recruitment, I cannot edit it later.