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Please select position(s) applying for:
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Field Safety Representative Entry Level
Field Safety Representative Experienced
Watchperson
Applicant Name
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Last
Address
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Do you approve of receiving text regarding job assignments?
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Email
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Do you have a valid driver license?
*
{Select One)
Yes
No
Do you have the requested safety certifications for the Field Safety Representative Entry Level position?
*
Yes
No
Do you have a minimum of 10 years construction experience and have OSHA and/or MSHA knowledge and are capable of providing the requested Field Safety Representative Entry Level duties?
Yes
No
Current Certifications
CHST Certification
CSP Certification
Other
Other Current Safety Certifications and/or Training:
Years of experience in Construction:
*
Experience in Construction Trade(s):
*
Construction Duties:
Safety Experience:
Safety Duties:
Employment History/Dates:
*
Projects worked on:
Upload Certifications / Training
Click or drag files to this area to upload.
You can upload up to 5 files.
(Up to 5 files: .doc, .docx, .pdf, .jpg, .png, .gif)
Computer Skills
*
(Select One)
Yes
No
Types of computer programs used:
If applicable, explain your confined space experience:
Are you a Safety Trainer/Topics?
*
Will you be willing to work at remote locations?
*
(Select One)
Yes
No
Would you be interested in short term projects (One day - Two Weeks)?
*
(Select One)
Yes
No
Requested Rate Per Hour:
*
Note: Depending on project Per Diem may be applied.
What time duration positions are you interested in:
*
On-Call
Long Term
Short Term
All
Years of experience as a Watchperson
*
Have you been newly trained?
Yes
No
Third Choice
Who was your former employer when you worked as a watchperson?
*
Which rail systems have you had experience with?
*
Which rail systems are you interested in working as a watchperson for?
*
BART
Caltrain
When does your 40-hour RWP training expire?
*
Do you have required rail system Personal Protective Equipment?
*
Yes
No
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