Consumer Support Services (CSS) Application

PLEASE PRINT OR TYPE: Read and answer all questions carefully and completely. You may attach resume; however all sections must be completed.

Name*

First Name

Last Name

Mailing Address*

Address Line 1

Address Line 2

City

State

ZIP Code

Phone Number*

Mobile Phone

If under 18, please list age

Email*

Upload your resume

No File Chosen

File uploads may not work on some mobile devices.

Upload a cover letter (optional)

No File Chosen

File uploads may not work on some mobile devices.

Education

High School

High School Location (mailing address)

Address Line 1

Address Line 2

City

State

ZIP Code

Years Completed

Major

Degree or Diploma

College or Business/Trade School

College or Business/Trade School (mailing address)

Address Line 1

Address Line 2

City

State

ZIP Code

Years Completed

Major

Degree or Diploma

Military

Have you even been in the Armed Forces?

Yes No

Date entered

Discharge date

Are you now a member of the National Guard?

Yes No

Specialty

Work Experience

Please list ALL work experience beginning with your most recent job held.

Employer 1

Name of supervisor at Employer 1

Hrs/week for Employer 1

Employer 1 Address

Address Line 1

Address Line 2

City

State

ZIP Code

Employer 1 Phone number

Employer 1 Start Date

Employer 1 End Date

Your last job title for Employer 1

Starting Salary for Employer 1 $

Final Salary for Employer 1 $

Reason for leaving Employer 1 (be specific)

List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at company 1.

May we contact Employer 1?

Yes No

Employer 2

Name of supervisor at Employer 2

Hrs/week for Employer 2

Employer 2 Address

Address Line 1

Address Line 2

City

State

ZIP Code

Employer 2 Phone number

Employer 2 Start Date

Employer 2 End Date

Your last job title for Employer 2

Starting Salary for Employer 2 $

Final Salary for Employer 2 $

Reason for leaving Employer 2 (be specific)

List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at company 2.

May we contact Employer 2

Yes No

Employer 3

Name of supervisor at Employer 3

Hrs/week for Employer 3

Employer 3 Address

Address Line 1

Address Line 2

City

State

ZIP Code

Employer 3 Phone number

Employer 3 Start Date

Employer 3 End Date

Your last job title for Employer 3

Starting Salary for Employer 3 $

Final Salary for Employer 3 $

Reason for leaving Employer 3 (be specific)

List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at company 3.

May we contact Employer 3

Yes No

References

Please include name, phone number, and circumstances of your acquaintance. Exclude relatives and former employers.

Reference 1

Reference 2

Reference 3

Reference 4

Clicking "I agree" and writing your name in the "Signature" field certifies that all answers and statements on this application are true and complete to the best of my knowledge. I understand that, should this application contain any false or misleading information, my application may be rejected or my employment with this company terminated.

I agree

Signature

Date*

Job Type

Additional Information

Education

High School

College or Business/Trade School

Military

Work Experience

References