JOB APPLICATION HELP

Please fill out the job application fields as completely as possible. The form consists of three basic sections and four yes or no questions. Please read through the yes or no questions carefully. A brief description of the information is listed below.

Your submission of this form with a valid email address indicates your agreement to the terms explained at the end of this document in lieu of a signature. If you are called in to an interview, you will be required to bring this information with you along with any supporting documentation and references, and you may be asked at that time to sign an agreement to the terms shown here online.

 General Information Section

Name - Your full name
Address - Your current mailing address
Phone # ? A number where you can be contacted, (000)000-0000.

SS# - Social Security Number, XXX-XX-XXXX
E-mail - A valid e-mail address where we can contact you.

Employment Record

Name of Employer - Business name of previous employer
Address - Business address of previous employer
From ? Beginning employment date
To ? Ending employment date
Starting ? Beginning salary, with notation ( /hr., /mos. or /yr.)
Ending ? Ending salary, with notation ( /hr., /mos. or /yr.)
Duties ? List position title and all duties assigned during employment, be as specific as possible.
Reasons ? List a specific reason for leaving the company.

Professional References ? Must be a co-worker or supervisor, someone you have worked with.

Name - Full name of reference
Address - Address of reference
Occupation - Occupation of reference
Phone - Phone number where reference can be contacted

Education

Name - Name of school attended
Address - Address of reference
Years - Number of years attended
Degrees - Degrees or certifications attained

Medical Information ? Check yes or no

Other ? List anyone working at CFS that you know.

Accuracy Statement ? Check yes or no as to the accuracy of the information on your application.