Fillable EMPLOYMENT APPLICATION For IN-HOUSE Toll Collector ONLY (State of Delaware)

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EMPLOYMENT APPLICATION For IN-HOUSE Toll Collector ONLY (State of Delaware)

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The EMPLOYMENT APPLICATION For IN-HOUSE Toll Collector ONLY (State of Delaware) form is 6 pages long and contains:

  • 1 signature
  • 18 check-boxes
  • 151 other fields

Country of origin: US
File type: PDF

U.S.A. forms for State of Delaware

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EMPLOYMENT APPLICATION
For IN-HOUSE Toll Collector ONLY
Name
Last First Middle Initial
Mailing Address, City, State & Zip
E-mail Address:
Home Phone:
Business Phone:
May we call you at work?
Yes No
Cell Phone:
Job Applied for: Toll Collector, IN-HOUSE ONLY
Job Location/Select:
Yes No Dover
Yes No Biddles Corner (Rt. 1 nr. Senator Roth Bridge)
Yes No Newark (I-95 Tolls)
Driver’s License
(State)
Number:
Expiration Date:
Employment Dismissals: Have you been involuntarily discharged or forced to
resign from State employment in the last 3 years? If yes, give details:
Yes No
The State requires verification of identity and eligibility for employment in the United States.
Are you lawfully permitted to work in the United States beyond a temporary period
without employment based sponsorship?
Yes No
Present State of Delaware Employee
Yes No
Merit
Other
Seasonal
Past State of Delaware Employee
Yes No
Merit
Other
Seasonal
State of Delaware Pensioner
(Receiving a Pension Check)
Yes No Retirement date
Personnel Use Only
JR’s __Yes __No
Comments:
Rater:____Date:____
11/18 Page 2 of 6
EDUCATION/TRAINING
Have you graduated from high school or passed the G.E.D.?
Yes No
Have you attended vocational and/or business school?
Yes No
Did you attend college, universities, or other technical schools beyond high school?
Yes No
If yes, give complete information in table below:
*A degree, as part of the Job Requirements, must have been issued from an accredited college or university in
order to meet the Job Requirements.
School Name
Location
Dates
Attended
Major/Minor
Type of
Degree
Received
Please list currently valid certification of professional or vocational competence/licenses and expiration date.
Other Job-Related Training:
License/Certification Registration Type
Issued by/Number
Expiration Date
Course Title
Training Provider
Dates Attended
11/18 Page 3 of 6
EMPLOYMENT HISTORY
Are you employed now?
Yes No
Beginning with your current or most recent position, state your employment history. A resume does not
substitute for this section of the application. This section must be completed.
Employed
Job Title:
Hourly or Annual
From:
Employer:
Salary:
Location:
Start:
MO/DD/YR
Supervisor Name:
Hours per Week
To:
Supervisor Title:
Supervisor Phone No.:
MO/DD/YR
Reason for Leaving:
Describe your duties:
Employed
Job Title:
Hourly or Annual
From:
Employer:
Salary:
Location:
Start:
MO/DD/YR
Supervisor Name:
Hours per Week
To:
Supervisor Title:
Supervisor Phone No.:
MO/DD/YR
Reason for Leaving:
Describe your duties:
Employed
Job Title:
Hourly or Annual
From:
Employer:
Salary:
Location:
Start:
MO/DD/YR
Supervisor Name:
Hours per Week
To:
Supervisor Title:
Supervisor Phone No.:
MO/DD/YR
Reason for Leaving:
Describe your duties:
Employed
Job Title:
Hourly or Annual
From:
Employer:
Salary:
Location:
Start:
MO/DD/YR
Supervisor Name:
Hours per Week
To:
Supervisor Title:
Supervisor Phone No.:
MO/DD/YR
Reason for Leaving:
Describe your duties:
11/18 Page 4 of 6
JOB REQUIREMENTS
Please describe how your education, training, and experience meet each Job Requirement below. Include all
work experience and skills related. Please do not submit copies of letters or training certificates, unless stated as
a requirement.
1. Knowledge of customer service such as providing prompt, accurate and courteous service to customers seeking
information, answering requests as quickly as possible, ensurin
g customers are satisfied with services, and
respond to complaints.
2. Knowledge or working with money and making change.
3. Knowledge of math such as addition, subtraction, multiplication, division, percentages, or decimals.
4. Knowledge of using an automated information system to enter, update, modify, delete, retrieve/inquire and report
data on.
Use additional pages if needed
11/18 Page 5 of 6
SUPPLEMENTAL JOB CONDITIONS FOR TOLL COLLECTOR
1. Knowledge of customer service which includes providing prompt, accurate, and courteous service to
customers, seeking information, answering requests as quickly as possible, ensuring customers are
satisfied with service, and responding to complaints.
2. Knowledge of working with money and making change.
3. Knowledge of math such as addition, subtraction, multiplication, division, percentages, or decimals.
4. Knowledge of using an automated information system to enter, update, modify, delete, retrieve/inquire
and report on data.
In addition to the meeting the job requirements, all candidates for this position need the following requirements
as well.
• Are you willing and able to work in a booth under adverse weather and environmental conditions
(i.e., hot, cold, rain, snow, exhaust fumes, etc.)? Yes ☐ No ☐
• Are you willing and able to lift and carry bundles weighing up to thirty (30) pounds for short distances if
required with or without an accommodation? Yes ☐ No☐
• If there were to be a power outage, are your math skills sufficient to add and subtract without the aid of a
calculator? Yes ☐ No☐
• Are you willing and able to work weekends, holidays, shifts and overtime? Yes ☐ No ☐
• Are you able to deal tactfully with customers, responding to questions and when confronted by rude or
irate people? Yes ☐ No☐
☐Yes I have read the above job conditions. To the best of my knowledge, the answers I have provided
are true and correct.
☐Yes If offered the position of Toll Collector, I agree to accept the conditions indicated as part of the
work requirements of the position.
11/18 Page 6 of 6
APPLICANT RELEASE OF EMPLOYMENT INFORMATION
READ THIS STATEMENT BEFORE SIGNING THIS APPLICATION:
Information provided on this application may be verified, including, but not limited to, contacting former
employers. Any false or substantive omission of information may be cause for rejection or dismissal if
employed by the State.
I authorize the release of any information from previous employers or references. If I am a current or former
employee of the State of Delaware, I acknowledge that my personnel records shall be subject to review by the
hiring agency.
By signing this application, I certify agreement with the terms given above for Applicant Release of
Employment Information.
By signing this application, I certify that I have read and understand the conditions of employment as stated
below. I also certify that this application was completed by me, that all entries on it are true, and that I seek
employment under these conditions.
• Child Support Compliance: State law requires that information on all hires (i.e. Name, Address, Social
Security Number, and Date of Hire) be reported to the State for the purpose of locating persons who owe
family support. The Division of Child Support Enforcement is authorized to request additional
employment and identifying information under special circumstances. Applicants will not be
disqualified from employment based on this information.
• Direct Deposit: As a condition of employment, direct deposit of paychecks is required for all new
employees.
• Immigration Law: At the time of hire, state employees must meet the documentation requirements of the
Immigration Reform and Control Act of 1986.
• Reference Check: Prior to appointment, your education and employment history are subject to
verification. At the time of a selection interview, candidates may be required to provide copies of
certificates, licenses, diplomas, and course transcripts.
Signature Date
An Equal Opportunity Employer
Accommodations are available for applicants with disabilities in all phases of the application and
employment process. To request auxiliary aid or service, please call (302) 739-5458 for assistance. TDD
users should call the Delaware Relay Service Number 1-800-232-5460 for assistance.
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EMPLOYMENT APPLICATION For IN-HOUSE Toll Collector ONLY (State of Delaware)

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Completed 20 July 2020

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