Job Application

APPLICATION FOR EMPLOYMENT (Printed version)

Website Job Application (Fill Online)

Date:

Name:

Phone:

Address:

Can you provide required proof of eligibility to work if you are under 18 years old?

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When can you start?

Would you be willing to travel?

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Which of these categories would you prefer (Check all that applies)?

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Describe

Position applying for:

Highest Grade Completed:

Have you ever been convicted of a motor vehicle offense such as a DWI, DUI, OMVI, Reckless Driving, etc.?

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If yes, please describe when and where:

Have you ever been convicted of a felony/misdemeanor involving theft or violence?

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If yes, please explain:

Do you have a valid driver’s license?

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Driver’s License #:

Type:

State:

Employer

Supervisor:

Employed from:

Hours per Week:

Position:

Starting Salary:

Ending Salary:

Employer:

Supervisor:

Employed from:

Employed from:

Position:

Starting Salary:

Ending Salary:

Employer:

Supervisor:

Employed from:

Hours per Week:

Position:

Starting Salary:

Ending Salary:

Employer:

Supervisor:

Employed from:

Hours per Week:

Position:

Starting Salary:

Ending Salary:

Please provide the required field.

Printed Name:

Type Name for Application Signature:

Date:

It is the policy of Cable Communication Services, Inc. not to discriminate, and to take affirmative action to provide fair and equal employment opportunity for all persons, regardless of race, color, sex, religion, national origin, and disability or Vietnam era veteran status. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation, and selection for training.