Application for Employment

Please fill out the partial application below, you will be required to fill out a complete application once we contact you.We consider applicants for all positions without regard to race, color, religion, sex, national origin, age, marital, or veteran status, the presence of non-job-related-medical condition or disability, or any other legally protected status.


Position(s) Applying For

How Did You Learn About Us? *



Street Address


State / Province / Region

Postal / Zip Code


Please answer the following questions:

If you are under 18 years of age, can you provide required proof of eligibility to work?YesNo

Have you ever filed an application with us before?YesNo

Have you ever been employed with CCI Company before?YesNo

Are you currently employed?YesNo

Are you prevented from lawfully becoming employed in this country because of Visa or Immigration Status?YesNo

Drivers License? YesNo

Past 3 years of Work Experience? YesNo


Any Training Certificates? YesNo

Training Certificates?


On what date would you be available to work?

Are you available to work:

  • Full Time
  • Part Time
  • Shift Work
  • Temporary
Shift preferred:

  • Day
  • Night
Please answer the following questions:

Are you currently on "lay-off" status and subject to recall?YesNo

Can you travel if a job requires it?YesNo

Can you work overtime, nights, weekends and/or holiday shifts when necesary?YesNo

Do you have any pre-existing injuries and or diseases that you know of, that may be affected by the proposed employment?YesNo

Have you ever been convicted of a felony?YesNo


I certify that answers given herein are true and complete to the best of my knowledge.

Spam Protection. Please answer this simple question.
What is "seven hundred" as a number?