On-Line Form

PERSONAL INFORMATION
Last Name(required)
First (required)
Street Address(required)
City(required)
State(required)
Zip(required)
Phone(required)
Email(valid email required)
How did you hear about us?(required)
Who referred you to CBS?
Date Available to work(required)
Desired Salary
Are you a U.S citizen?
YESNO
If no, are you authorized to work in the U.S?
YESNO
Have you ever worked for this company?
YESNO
If so, when?
EMPLOYMENT HISTORY - "CURRENT OR MOST RECENT"
Company(required)
Address(required)
Phone(required)
Supervisor
Your Job Title(required)
From(required)
To(required)
Job Duties(required)
Starting Salary(required)
Ending Salary(required)
May we contact your previous supervisor for a reference?
YESNO
Company(required)
Address(required)
Phone(required)
Supervisor
Your Job Title(required)
From(required)
To(required)
Job Duties(required)
Starting Salary(required)
Ending Salary(required)
May we contact your previous supervisor for a reference?
YESNO
PLEASE DESCRIBE YOUR RELEVANT MERCHANDISING EXP.
Experience
EDUCATION - HIGH SCHOOL
Name(required)
Address(required)
From(required)
To(required)
Did you graduate?
YESNO
EDUCATION - COLLEGE
Name
Address
From
To
Did you graduate?
YESNO
MILITARY
Have you ever served in the Military?
YesNo
If so, what branch
From
To
Type of Discharge
HonorableDishonorable
ADDITIONAL INFORMATION NEEDED
Are you able to merchandise product with the assistance of a schematic or plan-o-gram?
YESNO
Do you have the ability to print documents from your computer?
YESNO
Do you have the ability to upload files or pictures?
YESNO
Do you have a valid drivers license without restrictions?
YESNO
Do you have proof of auto insurance listing you as a driver?
YESNO
Ability to perform daily essential functions of lifting 10-50 lbs?
YESNO
Do you have any issues working with tobacco products?
YESNO
Willing to authorize a background check and pass a drug test?
YESNO
REFERENCES - Please list two professional references
Full Name(required)
Relationship(required)
Company(required)
Phone(required)
REFERENCE #2
Full Name(required)
Relationship(required)
Company(required)
Phone(required)
DISCLAIMER AND SIGNATURE
I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may lead to my release
Signature(required)
Date(required)