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Applications Entry

CrossPoint Employment Application

First Name

Last Name

Position you are applying for

Email

Phone Number

Current Address

Your Facebook Address

Your Instagram Account Name

Are You Eligible to Work in the US?

Yes No

Are you over 18 at this time?

Yes No

Please upload your resume in PDF format

Upload

Please enter your past employment information, beginning with your current or most recent employer.

(1) Employer Name

Employer Phone Number

Employer Address

Position(s) Held

Responsibilities

Employment Start Date

Employment End Date

Starting Pay

$

Ending Pay

$

Type

Hourly Salary

Supervisor First Name

Supervisor Last Name

May we contact your supervisor?

Yes No

Reason for leaving?

(2) Employer Name

Employer Phone Number

Employer Address

Position(s) Held

Responsibilities

Employment Start Date

Employment End Date

Starting Pay

$

Ending Pay

$

Type

Hourly Salary

Supervisor First Name

Supervisor Last Name

May we contact your supervisor?

yes no

Reason for leaving?

(3) Employer Name

Employer Phone Number

Employer Address

Position(s) Held

Responsibilities

Employment Start Date

Employment End Date

Starting Pay

$

Ending Pay

$

Type

Hourly Salary

Supervisor First Name

Supervisor Last Name

May we contact your supervisor?

yes no

Reason for leaving?

Please list two references.

Reference (1) Name

Reference (1) Email

Reference (1) Phone

Length of Time Known

Relationship to You

Reference (2) Name

Reference (2) Email

Reference (2) Phone

Length of Time Known

Relationship to You

How did you learn about this job opening?

Why are you interested in working here?

Is there any reason that would make you unable to perform all physical aspects of the position you are applying for?

What salary would you need for you and your family to consider this position?

$

What is the minimum number of hours you would like to work per week?

What is the maximum number of hours you would like to work per week?

Please tell us about your connection to CrossPoint.

Describe any experiences, education, training, or special skills you have that may be applicable to this position:

How would you describe yourself?

Why does this position interest you?

Have you ever been fired or otherwise asked to leave a job?

How many work days, other than planned vacation days, have you missed in the last two years?

Electronic Signature

Today's Date

Submit

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