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Application for Employment

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

 

Date:_______________

Last Name:_______________ First Name:_______________ Middle Initial:_____

Street Address:__________________________________________________________

City:_______________________________ State:________________ ZIP:________

Telephone:__________________________

Are you a U.S. citizen or otherwise authorized to work in the U.S.
on an unrestricted basis?

(You may be required to provide documentation)

Are you looking for full-time employment?__________

If no, what hours are you available?________________________________

Are you willing to work on weekends?_______________

Have you ever been convicted of a felony?__________

If yes, please describe conditions:_____________________________________________

 

Employment Desired

 

Position applied for:__________________________________________________________________

How did you hear of this opening?:_________________________________________

When?:_____________________________________ Where?:________________________________

Are you presently employed?:______________

May we contact your present employer?:____________

Are you available for full-time work?:____________

Are you available for part-time work?:____________

Will you relocate?:____________

Are you willing to travel?:___________ If yes, what percent?:_______________

Date you can start?:_____________________________________

Signature:______________________________________ Date:__________________________



Please feel free to fill out our employment application and E-mail it to us at dcottam@ccisca.com

1111 Howe Ave, Suite 535, Sacramento, CA 95825                   Phone: (916) 488-4426                               Fax: (916) 488-4796    
                                                                                                        License #0F19705

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