Application For Employment |

Date

MM

DD

YYYY

Name*

FirstLast

Address*

Street AddressAddress Line 2CityStateZip Code

Phone*

Email*

Position Applied For*

Date Available for Work

Desired Pay Rate

Are you over 18 years old?*

Yes
No

Type of Employment Desired

Have you ever been employed here before? If yes, give dates and position.*

If hired, can you provide documents required to establish your eligibility to work in the U.S.?*

Yes
No

Have you ever been convicted of, or pled guilty or no contest to, a crime (felony or misdemeanor) other than a minor traffic violation?*

Yes
No

If yes, please explain in detail and include the date of final disposition of the case and the nature of the offense. This information will not necessarily disqualify you from employment but false or misleading information will. Factors such as age and time of the offense, seriousness and nature of the violation, and rehabilitation will be taken into account.

Education

Please provide the following:

High School or Last Grade Completed

Education Address 1

Street AddressAddress Line 2CityStateZip Code

Years Completed 1

Degree Type 1

College or Technical School

Education Address 2

Street AddressAddress Line 2CityStateZip Code

Years Completed 2

Degree Type 2

Other Schooling or Training

Education Address 3

Street AddressAddress Line 2CityStateZip Code

Years Completed 3

Degree Type 3

Military Service

Branch of Services

Rank / Type of Service

Are you a Vietnam Veteran?

Yes
No

Were you Honorably Discharged?

Yes
No

Most Recent Employer

Company Name

Address (most recent)

Street AddressAddress Line 2CityStateZip Code

Phone

Start Date

End Date

Job Title

Supervisor Name

Duties

Salary

Reason for Leaving

May we contact this employer?

Yes
No

Second Most Recent Employer

Company Name

Address

Street AddressAddress Line 2CityStateZip Code

Phone

Start Date

End Date

Job Title

Supervisor Name

Duties

Salary

Reason for Leaving

May we contact this employer?

Yes
No

Third Most Recent Employer

Company Name

Address

Street AddressAddress Line 2CityStateZip Code

Phone

Start Date

End Date

Job Title

Supervisor Name

Duties

Salary

Reason for Leaving

May we contact this employer?

Yes
No

Personal References

Please do not include relatives.

Reference Name 1

Occupation

Phone

Years Known / Relationship

Reference Name 2

Occupation

Phone

Years Known / Relationship

Reference Name 3

Occupation

Phone

Years Known / Relationship

STATEMENT (Please read this statement carefully before signing this application)*

I understand that employment with CFS is at-will, meaning that I or the CFS may terminate my employment at any time, or for any reason consistent with applicable state or federal law. I authorize the CFS to conduct a thorough background investigation of my work and personal history, and verify all data given on this application and during interviews. I hereby release CFS, and its representatives or agents, from any liability that might result from such an investigation. I authorize all individuals, schools, and firms named to provide any requested information and release them from all liability for providing the requested information. I agree that any claim or lawsuit relating to my service with CFS or any of its subsidiaries must be filed no more than six (6) months after the date of the employment action that is the subject of the claim or lawsuit. I waive any statute of limitations to the contrary. I understand that CFS requires the successful completion of a drug and/or alcohol test as a condition of employment. I understand this application will be active for a period of 90 days; after that time, if I wish to be considered for employment, I must submit a new application. I certify that all the statements in this completed application are true and understand that any falsification or willful omission shall be sufficient cause for dismissal or refusal to hire.

Name

This field is for validation purposes and should be left unchanged.

Application For Employment