This application will be considered only for the specific job applied for. If you desire to be considered for another position at a future time, you must submit a new application. GENERAL INFORMATION Name (Last) (First) (Middle Initial) Home Telephone ( ) - Address (Mailing Address) (City) (Zip) Telephone (State) ( ) - E-Mail Address ☐ Yes ☐ No Are you legally eligible to work in the U.S.? POSITION Position or Type of Employment Desired Will Accept: Shift: ☐ ☐ Part-Time Day ☐ ☐ ☐ Yes ☐ No Full-Time Swing Are you able to lift 75 pounds safely and without injuring yourself? If not please explain: ☐ ☐ Temporary Rotating How did you learn of this position? ☐ On-call Wage or Salary Desired Date Available EDUCATION AND TRAINING ☐ Yes ☐ No High School Graduate or General Education (GED) Test Passed? If no, list the highest grade completed College, Business, Technical, or Military schooling (Most recent first) Degree Major Attended Name and Location Graduate & Year or Subject Month/Year From ☐ Yes To ☐ No From ☐ Yes ☐ No To From ☐ Yes To ☐ No VETERAN INFORMATION (Most recent) Branch of Service Period of active duty Rank at discharge From: To: Briefly describe duties / specialized training SPECIAL SKILLS & QUALIFICATIONS (List all pertinent skills and equipment that you can operate) Types of computers, software, and other equipment you are qualified to operate: Professional licenses or certifications: Specialized equipment experience: Additional languages: 10 key: kph Typing speed: wpm Organizations and volunteer activities:
This application will be considered only for the specific job applied for. If you desire to be considered for another position at a future time, you must submit a new application. GENERAL INFORMATION Name (Last) (First) (Middle Initial) Home Telephone ( ) - Address (Mailing Address) (City) (State) (Zip) Telephone ( ) - E-Mail Address Are you legally eligible to work in the U.S.? ☐ Yes ☐ No POSITION Position or Type of Employment Desired Will Accept: ☐ Part-Time ☐ Full-Time ☐ Temporary ☐ On-call Shift: ☐ Day ☐ Swing ☐ Rotating Are you able to lift 75 pounds safely and without injuring yourself? ☐ Yes ☐ No If not please explain: How did you learn of this position? Wage or Salary Desired Date Available EDUCATION AND TRAINING High School Graduate or General Education (GED) Test Passed? ☐ Yes ☐ No If no, list the highest grade completed College, Business, Technical, or Military schooling (Most recent first) Name and Location Attended Month/Year Graduate Degree & Year Major or Subject From ☐ Yes ☐ No To From ☐ Yes ☐ No To From ☐ Yes ☐ No To VETERAN INFORMATION (Most recent) Branch of Service Period of active duty From: To: Rank at discharge Briefly describe duties / specialized training SPECIAL SKILLS & QUALIFICATIONS (List all pertinent skills and equipment that you can operate) Types of computers, software, and other equipment you are qualified to operate: Professional licenses or certifications: Specialized equipment experience: Additional languages: 10 key: kph Typing speed: wpm Organizations and volunteer activities:
CM-Employee-Application-word-doc.docx