Thursday August 17, 2017
 
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Employment Application


Application Identification
First Name:  
Last Name:  
Middle Initial:  
     
Address:  
City:  
State:  
Zipcode:  
     
Phone (including area code):  
Email:  
     
Social Security Number:  
     
Are you legally eligible for employment in the united states?  

 

Job Interests
Position Desired:  
Salary Requirement:  
Status Preference:  
Shift Preference:  
Date available for work:  
     
General Information    
How were you referred to us?  
Have you ever applied here before?  
List friends or relatives now employed here:  

 

Education
High School:  
City & State:  
Did you graduate?:  
     
College:  
City & State:  
Did you graduate?  
Majors:  
Degree:  
     
     

References

   
List name, address and phone number of three business references not related to you.  

 

Employment Information
Starting with your present or last employer, list all jobs held. Include all work experience whether or not it is related to the job for which you are applying. (Attach additional sheet if necessary.)
Company Name:  
Address, City, State:  
Position:  
Duties:  
Supervisors name:  
Phone number:  
Reason for leaving:  
Dates:   From: To:
Salary:  
     
Company Name:  
Address, City, State  
Position:  
Duties:  
Supervisors name:  
Phone number:  
Reason for leaving:  
Dates:   From: To:
Salary:  
     
Company Name:  
Address, City, State  
Position:  
Duties:  
Supervisors name:  
Phone number:  
Reason for leaving:  
Dates:   From: To:
Salary:  
     

 

Acknowledgment

CTC does not discriminate in hiring or employment on the basis of age, race, religion, color, sex, physical or mental disability, sexual orientation, national origin, Vietnam Era veteran status or disabled veteran status. No question on this application is intended to secure information to be used for such discrimination.

This application will be given every consideration, but its receipt does not imply that the applicant will be employed.

I certify that all information provided in this application is accurate and complete to the best of my knowledge. I authorize the verification and release of information and the release of references, grade transcripts, felony conviction background, and additional information pertinent to my employment from sources identified in this application. Providing false information may result in discharge.

I understand that if employed, I may be required to submit proof of citizenship or legal right to remain in the United States.

I understand the employment for which I am applying may be terminated by either me or by CTC at any time and for any reason. I further understand that no employee of CTC, other than its Board of Directors, has the authority to enter into any employment contract.

I hereby acknowledge that I have read the above statement and understand the same.

Type your full name as digital signature.

 

Applicant/Employee Consent and Release
Drug-free workplace program

I hereby voluntarily consent to a drug test, including the collection of a sample of my urine, for the purpose on urinalysis pursuant to CTC Teleservices drug policy. I acknowledge that I have been given notice of the Drug Policy and that I understand it. I further consent to the disclosure of the test result(s) and any test related information by and between CTC Teleservices collection facility, testing laboratory, medical review officer and appropriate supervisory and managerial personnel.

Type your full name as digital signature.


Release Authorization
I hereby authorize, without reservation, CTC Teleservices and the directors, officers, affiliates, employees, and agents, as condition of employment or as a condition or continuing employment, to contact any of my previous employers or to contact schools, companies, credit bureaus, law enforcement agencies, government agencies, persons and educational institutions to supply any information concerning my background and to furnish the above listed information and to release and hold harmless all parties involved from any liability and responsibility for doing so. This authorization and concent shall be valid in original, facsimile, or copy form.

Type your full name as digital signature.
     
   

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