Our policy is to provide equal employment to all qualified persons without regard to race, creed, color, religious belief, gender, age, national origin, ancestry, physical or mental disability or veteran status.

About You
First Name*
Middle Name
Last Name*
Your Address
Street*
City*
State*
ZIP*
Your Contact Details
Telephone*
EMail*
Desired Position
Requested position?*
How did you hear about us?*
When can you start?*
Desired hourly wage?*
Work Details

Are you a U.S. citizen or otherwise authorized to work in the United States on an unrestricted basis? (You may be required to provide documentation)
 Yes No
Are you looking for full-time employment?
 Yes No
If no, what hours are you available?
Are you willing to work swing shifts?
 Yes No
Are you willing to work the graveyard shift?
 Yes No
Have you ever been convicted of a felony? (This will not necessarily impact your application)
 Yes No
If yes, please describe the circumstances

High School Education
School Name*
School Location*
Graduation Year*
College Education
College Name
College Location
Graduation Year
Major
Degree

In addition to your work history, are there other skills, qualifications or experience we should consider?

Work Experience: Most Recent Job
Company Name
Company Address
Telephone
Date Started
Date Ended
Supervisor Name

May we contact your supervisor?
 Yes No
Reason for leaving

Work Experience: Second Most Recent Job
Company Name
Company Address
Telephone
Date Started
Date Ended
Supervisor Name

May we contact your supervisor?
 Yes No
Reason for leaving

Please forward any additional information with your name to ccmaint@yahoo.com.

I certify the facts set forth in this application for employment are true and complete to the best of my knowledge. I understand that if I am employed, false statements on this application shall be considered sufficient cause for dismissal. This company is hereby authorized to make any investigation of my prior educational and employment history.

I understand that employment is "at will," which means that either I or this company can terminate the employment relationship at any time, with or without prior notice, and for any reason not prohibited by any statute. All employment is continued on that basis. I understand that no supervisor, manager, or executive of this company, other than the president, has any authority to alter the forgoing.

Your Agreement

I agree to all of these terms set forth. *
(You must agree to submit this form and your job application)