CSM America Employment Application

APPLICATION FOR EMPLOYMENT
CSM America considers all applicants for employment without regard to: Age, Disability, Genetic Information, National Origin, Pregnancy, Religion, Sex, Vietnam Era, Special, Race, or Color in accordance with federal law. In addition, CSM America complies with applicable state and local laws prohibiting discrimination in employment in every jurisdiction in which it maintains facilities. CSM America also provides reasonable accommodations to individuals with disabilities in accordance with applicable laws.
E-Verify Notification: Federal laws require that employers hire only individuals who are authorized to be lawfully employed in the USA. IN compliance with such laws, CSM America will verify status of every individual offered employment with the Company. In this connection, all offers of employment are subject to verification of the applicant's identity and employment authorization, and it will be necessary for you to submit such documents are required by law to verify your identification and employment authorization.
Position Desired

Cleaning Professional *No Experience Required Floor Care Specialist (Technician) *Experience Required Supervisor *Experience Required
How did you hear about this opening?

Previous/Current Employee of CSM America Job Board (Indeed, Snagajob, etc). Job Fair
Name *

First Name Middle Initial Last Name

Current Address *

Street Address (PO BOX NOT ACCEPTED)
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Are you 18 or over

Yes No (If under 18, you must provide Employment and/or Age Certification, as required by the State that you reside, in order to be considered for employment.)
Primary Phone Number *

Area Code Phone Number
Alternate Number

Area Code Phone Number
Date You Can Start:

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Have you ever been employed by CSM America? *

Yes No
Provide Year and Location
Background Information
Are you currently authorized to work for all employers in the USA on a full-time basis or only for your current employer? *

All Employers Current Employer only
Are there any restrictions on the hours you can work, to include overtime if required? *

Yes No
Please explain:
Do you have experience buffing, waxing, honing, scrubbing, and/or stripping floors? *

Yes No
Do you have experience working with heavy duty equipment, forklifts, and/or pallet jacks? *

Yes No
Do you have experience supervising other employees? *

Yes No
Are you comfortable delagating? *

Yes No
Are you comfortable holding employees accountable? *

Yes No
Do you know how to motivate others? *

Yes No
Is there anything that would prevent you from performing, in a reasonable and safe manner, the activities involved in the position for which you are applying? *

Yes No
Have you been convicted of a felony within the last five (10) years? *

Yes No
Type of crime
Place of occurence
City, State
Court:
Disposition of Case:
Note: Conviction of a crime will not necessarily disqualify you for employment. Each conviction will be judged on its own merit with respect to time and job relatedness.
WORK HISTORY
Current / Most Recent Employer: *
Name of Company
Dates from: *

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Dates to: *

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City & State: *
Company Phone Number:

Area Code Phone Number
Job Title & Duties:
Starting Pay: $
Ending Pay: $
Reason for Leaving: *
Name of Company:
Dates from:

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Dates to:

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City & State:
Company Phone Number:

Area Code Phone Number
Job Title & Duties:
Starting Pay: $
Ending Pay: $
Reason for Leaving:
Name of Company:
Dates from:

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Dates to:

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City & State:
Company Phone Number:

Area Code Phone Number
Job Title & Duties:
Starting Pay: $
Ending Pay: $
Reason for Leaving:
EDUCATION DATA
Highest Level of Education you have Completed: *
Did you graduate? *

Yes No
When did you graduate?

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List College Degree(s) and Date(s) Attained:
List Other Educational/Special Training and Dates:
CONFIDENTIAL ... EQUAL OPPORTUNITY/AFFIRMATIVE ACTION DATA (Please Read Before Completing). CSM America is an Equal Opportunity/Affirmative Action employer and subject to certain reporting requirements. The information requested below is so that we may meet our Equal Opportunity/Affirmative Action obligations. Your completion of this section of the application is purely voluntary and will not affect your consideration for employment in any way.
Name AND Last 4 Digits of SS# *

First Name Last Name Last 4 Digits of SS#
Position Desired

Cleaning Professional *No Experience Required Floor Care Specialist (Technician) *Experience Required Supervisor *Experience Required
Do you wish to provide this information? *

Yes No *Please complete the information above ONLY, sign and date below.
Please check the appropriate gender:

Male Female
Please check the appropriate race/ethnic group:

Black/African American (Not of Hispanic Origin) Hispanic/Latino American Indian/Alaska Native White/Caucasian Asian Native Hawaiian/Other Pacific Islander Two/More Races (a person who primary identifies with 2 or more of the above races/ethnicity categories)
Please check the appropriate Veteran Status:

Veteran Vietnam Era Veteran Disabled Veteran
JOB APPLICANT AGREEMENT & RELEASE AUTHORIZATION- PLEASE READ CAREFULLY: I understand that Corporate Services Management (CSM America) requires certain information about me to evaluate my qualifications for employment and to conduct its business should I become an employee. I understand that false, incomplete or misleading statements on this application is sufficient cause for my dismissal, if and when discovered. The use of this application or the return of this application to an employee or designee of CSM America does not indicate there are positions presently open and does not in any way obligate CSM America, or is it in itself an offer of employment with CSM America. I authorize CSM America, or its agent(s), to contact former employers, schools and governmental/law enforcement agencies to verify the information given on this application and during the interview process.
Complete Signature of Applicant *

Clear
Date

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Thank you for applying to CSM America. If you are selected, we contact you with next steps.
Should be Empty:

APPLICATION FOR EMPLOYMENT

Background Information

Note: Conviction of a crime will not necessarily disqualify you for employment. Each conviction will be judged on its own merit with respect to time and job relatedness.