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Applications Entry
CrossPoint Employment Application
First Name
Last Name
Position you are applying for
Email
Phone Number
Current Address
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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
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SD
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WV
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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
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AK
AS
AZ
AR
CA
CO
CT
DE
DC
FM
FL
GA
GU
HI
ID
IL
IN
IA
KS
KY
LA
ME
MH
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
MP
OH
OK
OR
PW
PA
PR
RI
SC
SD
TN
TX
UT
VT
VI
VA
WA
WV
WI
WY
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
AL
AK
AS
AZ
AR
CA
CO
CT
DE
DC
FM
FL
GA
GU
HI
ID
IL
IN
IA
KS
KY
LA
ME
MH
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
MP
OH
OK
OR
PW
PA
PR
RI
SC
SD
TN
TX
UT
VT
VI
VA
WA
WV
WI
WY
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?
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