CSS Jobs Interface

Application
CSS Jobs Interface will not discriminate on the basis of race, color or national origin.
E-mail Address*
example@example.com
Name*

FirstMiddleLast
Date of Birth*

MonthDayYear
Social Security/ ITIN Number*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Telephone*
Work Status:*

Independent Contractor (must upload completed W9 form below)*Temporary Worker
What position are you applying for?
Are you a US Citizen*

YesNo
Confirm that you can legally work in the US, or close this form to end your application*

I am Authorized to work in the United States
Have you ever worked for this company*

YesNo
If 'Yes' Explain, otherwise enter 'NA'*
Have you ever been convicted of a felony*

YesNo
If 'Yes' list Convictions, otherwise enter 'NA'
EDUCATION
High School*
Start Date

MonthDayYear
End Date

MonthDayYear
Did you graduate

YesNo
What certification did you receive?
College
Start Date

MonthDayYear
End Date

MonthDayYear
Did you graduate

YesNo
Certifications
Trade Schools
When did you start?

MonthDayYear
When did you leave?

MonthDayYear
Did you graduate?

YesNo
Trade School Certifications Received
WORK HISTORY

Three Years
Company
Start Date

MonthDayYear
End Date

MonthDayYear
Reason for leaving
Company
Start Date

MonthDayYear
End Date

MonthDayYear
Reason for leaving
Company
Start Date

MonthDayYear
End Date

MonthDayYear
Reason for leaving
RELEVANT SKILLS/ ABILITIES
List here (separate with commas)
Select all that apply

CarpentryClerical or AdministrativeDry Wall InstallationElectrical WiringFactory ProductionFork Lift Driving and HandlingLandscapingMachine OperationMaintenanceMicrosoft and Google SuitesPlumbingWeldingOther
Do you possess a valid drivers license*

NoYes
If 'Yes' list Special Endorsements, otherwise enter 'NA'*
THREE PROFESSIONAL REFERENCES
Name*

FirstLast
Relationship*
Telephone*
Name*

FirstLast
Relationship*
Telephone*
Name*

FirstLast
Relationship*
Telephone*
SUPPORTING DOCUMENTS
Click Here to Upload any Supporting Documents (eg. a Resume or Letter)

Upload a File

Cancelof
Click Here to Upload Your Government Issued ID (Mandatory)*

Upload a File

Cancelof
Independent Contractors MUST Download, Complete and Sign the W9 Form.
Click Here to Upload Your Signed W9 Form (Mandatory)*

Upload a File

Cancelof
Read Before Signing This Form

By signing and submitting this form I hereby state that all information provided is accurate and may be verified by CSS Jobs Interface.
Type Full Name as it appears on your Government Issued ID*
Typed name represents my legal signature
Enter the message as it's shown*
Should be Empty:

Application

EDUCATION

WORK HISTORY

RELEVANT SKILLS/ ABILITIES

THREE PROFESSIONAL REFERENCES

SUPPORTING DOCUMENTS

Read Before Signing This Form