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Personal InformationName* First Middle Initial Last Address* Address Line 1 Address Line 2 City State ZIP Phone*Email* General InformationPosition Applied For* I am Seeking (check only one):* Full-time Part-time Temporary Employment Internship I am available for:* Full-time Part-time If Part Time, indicate max hours per week Date on which you can start work if hired:* MM slash DD slash YYYY Are you willing to work overtime?* Yes No Desired Salary/Hourly Rate* Have you previously applied for employment with Control Chief Corporation?* Yes No If you answered yes to the previous question, when & where did you apply? Have you ever been employed with Control Chief Corporation?* Yes No If you answered yes to the previous question, provide position, dates of employment & reason for separation from employment.If hired, can you present evidence of U.S. Citizenship or your legal right to work in this country?* Yes No Have you ever been convicted of a crime?* Yes No If yes, describe in full. (include dates and states):Will you travel if your job requires it?* Yes No EducationEducation History*Education (High School, College, etc.)School Name & LocationGraduate? Y or N# of Years CompletedDegree/Major Honors ReceivedMilitary ExperienceList branch of service, length of service, and.or training received. A copy of your degree and.or certificates will be required upon hire.Work ExperiencePlease list the names of your present and/or previous employers in chronological order with present or most recent employer listed first. Provide information for at least the most recent ten (10) year period. Upload additional sheets if needed. If self-employed, supply firm name and business references. You may include any verifiable work performed on a volunteer basis, internships, or military service. Your failure to completely respond to each inquiry may disqualify you for consideration from employment. Do not answer “see resume.”Employer* Name Address Type of Business Phone*Date* MM slash DD slash YYYY Date* MM slash DD slash YYYY Job Title* Specific Duties* Supervisor's Name* May we contact?* Yes No Last Salary*Reason for leaving* __________________________Employer Name Address Type of Business PhoneDate MM slash DD slash YYYY Date MM slash DD slash YYYY Job Title Specific Duties Supervisor's Name May we contact? Yes No Final SalaryReason for leaving __________________________Employer Name Address Type of Business PhoneDate MM slash DD slash YYYY Date MM slash DD slash YYYY Job Title Specific Duties Supervisor's Name May we contact? Yes No Last SalaryReason for leaving Special SkillsList any special training, skills, or abilities relevant to the position for which you are applying (e.g. CPR, First Aid Training, Technical Certificates, etc)Professional References*Please list the names of additional work-related references we may contact. Individuals with no prior work experience may list school or volunteer-related experiences. NamePositionCompanyWork Relationship (i.e., supervisor, co-worker)Telephone Personal References*Please list the names of personal references (not previous employers or relatives) who know you well that we may contact.NameOccupationAddressTelephone NumberNumber of Years Known ResumeYou may send resume, or other documentation to hr@controlchief.comApplicant CertificationI certify information provided is true and complete. I authorize investigation of all statements contained in this application for employment. This application shall be considered active for 90 days after which a new application will be required. I understand an employment relationship with Control Chief Corporation is "at will", which means an Employee may resign at any time and the Employer may discharge Employee at any time without cause. "At Will" employment may not be changed except in writing by the Human Resources Coordinator. I authorize Control Chief Corporation to obtain information from employer(s) and school(s) attended. I authorize employer(s) and school(s) to disclose to Control Chief Corporation such information as may be requested about me, including but not limited to copies of evaluations, transcripts, and any information regarding disciplinary actions and performance. I authorize Control Chief Corporation to conduct background checks including drug screening and criminal background checks. I release Control Chief Corporation and schools and employers from any liability associated with furnishing information as specified above. In the event of employment, I understand that false or misleading information given in my application or interview may result in discharge. I understand, also, that I am required to abide by policies, rules, regulations and laws applicable to employment.Electronic ConfirmationBy clicking the "SUBMIT" button below, I confirm that I understand and agree to the Application Certification Terms listed above. I am also affirming that the information I listed on this application is true and correct. Section BreakCommentsThis field is for validation purposes and should be left unchanged. Δ
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