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Join CMC: Employment Application Form
We are an Equal Opportunity Employer and fully subscribe to the principles of Equal Employment Opportunity. Applicants and/or employees are considered for hire, promotion and job status, without regard to race, color, religion, creed, sex, marital status, national origin, age, physical or mental disability.
Please fill out the Employment Application below
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Indicates required field
Name (Last)
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First
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Middle
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Date of Application
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Address
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City
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State
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ZIP
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Home Phone
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Mobile Phone
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Email
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1. General Information:
Are you able to perform the essential job functions of the position for which you are applying with or without reasonable accommodation?
Select One
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Yes
No
Have you been convicted of any felonies other than minor traffic violations during the past seven years? (A criminal record or a conviction will not automatically bar employment, but will be considered only as it reasonably relates to your fitness to perform in the position for which you are applying)
Select One
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No
Yes
If yes, please explain:
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2. Education & Training:
Check last grade completed:
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1
2
3
4
5
6
7
8
9
10
11
12
Major course studied:
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Graduated or degree?
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Yes
No
Average grade:
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College/Univ./Tech/Vocational
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1
2
3
4
Masters
Doctorate
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Name of School
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Address of School
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List any scholarships, academic honours, awards, special achievements:
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3. Skills
(Please list any skills that you have that are appropriate for the position you are applying for)
Skill sets:
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If required will you work: (Check all that apply)
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Rotating shifts
Overtime
Saturdays
Sundays
Check all that apply
Position applying for, be specific:
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Salary Requirement in Dollars $
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Per:
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Hour
Month
State fully why you believe you are qualified for this position:
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Interests/Accomplishments:
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Employment History
Starting with your PRESENT Most Recent Employer, list in consecutive order ALL EMPLOYMENT for at least the past FOUR employers.
If currently employed may we contact your employer?
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Yes
No
Full Name of Company
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Phone Number
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Address
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Line 1
Line 2
City
State
Zip Code
Country
Name of Supervisor
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First
Last
Title of Supervisor
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Title of Your Position
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Beginning Salary
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Ending Salary
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Start Date (Month/Year)
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End Date (Month/Year)
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Reason for Leaving:
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Full Name of Company
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Phone Number
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Address
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Line 1
Line 2
City
State
Zip Code
Country
Name of Supervisor
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Title of Supervisor
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Title of Your Position
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Beginning Salary
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Ending Salary
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Start Date (Month/Year)
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End date (Month/Year)
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Reason for Leaving:
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[object Object]
Full Name of Company
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[object Object]
Phone Number
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Address
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Line 1
Line 2
City
State
Zip Code
Country
Name of Supervisor
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[object Object]
Title of Supervisor
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Title of Your Position
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Beginning Salary
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[object Object]
Ending Salary
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Reason for Leaving:
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[object Object]
Full Name of Company
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[object Object]
Phone Number
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[object Object]
Address
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Line 1
Line 2
City
State
Zip Code
Country
[object Object]
Name of Supervisor
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[object Object]
Title of Supervisor
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[object Object]
Title of Your Position
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[object Object]
Beginning Salary
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Ending Salary
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[object Object]
Reason for Leaving:
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READ CAREFULLY:
I certify that the information contained in this application is correct to the best of my knowledge and understand that any misstatement or omission of information may result in denial of employment or discharge. I authorize the references listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release all parties from all liability for any damage that may result from furnishing same to you. I agree that by typing my name in the signature box below
constitutes signing the record electronically.
Signature
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Date (MM/DD/YYYY)
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Submit
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