Personal Information

    First Name*
    Middle Name
    Last Name*
    Email*
    Address*
    City*
    State*
    Zip*
    Telephone*
    Are you 18 years or older?*
    NoYes
    Are you prevented from lawfully becoming employed in this country because of visa or immigration status? Proof of citizenship/immigration status will be required.*
    NoYes
    Have you been convicted of a felony in the last 7 years?*
    NoYes

    Employment Desired

    Requested Position*
    Date you can start*
    Have you been employed with us before?*
    NoYes
    Dates you were employed
    From
    To
    Are you currently employed?*
    NoYes
    May we contact your present employer?
    NoYes

    Employment History

    Employer*
    Address*
    Telephone*
    Job Title*
    Supervisor*
    Employed
    From*
    To*
    Wage/Salary*

    Applicant's Statement

    I certify that the answers given herein are true and complete to the best of my knowledge. I authorize investigation of all the statements contained in this application for employment as may be necessary in arriving at an employment decision. This application for employment shall be considered active for a period of time not to exceed 45 days. Any applicant wishing to be considered for employment beyond this period should inquire as to whether or not applications are being accepted at that time.

    I hereby understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with this organization is of an "at will" nature, which means that the Employee may resign at any time and the Employer may discharge Employee at any time with or without cause. It is further understood that this "at will" employment relationship may not be changed by any written document or by conduct unless such change is specifically acknowledged in writing by an authorized executive of this organization. Any dispute which arises between employer and employee must be resolved by arbitration in accordance with the rules of the American Arbitration Association. In the event of employment, I understand that false or misleading information given in the application or interview(s) may result in discharge. I also understand that I am required to abide by all rules and regulations of the employer.

    Full Name* (Signature)
    Date*

    C&S Lease Service is an equal opportunity employer and does not discriminate on the basis of race, color, religion, gender, age, sexual orientation, national origin or ancestry, physical or mental disability, marital status, pregnancy, veteran status, medical condition, or any other protected status as defined by the law.