Employment Application
 
Date: / / SSN# - -
First Name: Middle Name:
Last Name: Telephone:
Present Address: City:
State: Zip:    
 
Employment Desired
 
What kind of work are you applying for?
Regular full-time work Yes No  
What days are you available for work?
Are you available for work on the weekends? Yes No
Over time if necessary? Yes No  
If hired what day can you start?
Desired Salary?
 
Personal Information
 
Have you ever applied for or worked for CBC before?
Yes No
If yes, when?
Do you have any friends or relatives currently working for CBC?
Yes No
Why did you leave/going to leave your last position?
If hired, would you have a reliable means of transportation to and from work?
Yes No
Specify means of transportation:
Are you 18 or older?
Yes No
Have you ever been convicted of any crimes, other than minor traffic violations?
Yes No
If yes, state the nature of the crime(s), when and where convicted and disposition of the case:


 
(Note: no applicant will be denied employment solely on the grounds of conviction of a criminal offense. The nature of the offense, the date of the offense, the surrounding circumstances and the relevance of the offense to the position applied for may, however, be considered.)

 
Education, Training and Experience
 
School Name and Address Years completed Did you Graduate?               Yr?
High School Yes No
College Yes No
Vocational Yes No
 
List any other experience, training, qualifications or skills you feel make you suited for work at CBC: