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Applications Entry

CrossPoint Employment Application

First Name

First Name is required.

Last Name

Last Name is required.

Position you are applying for

Position you are applying for is required.

Email

Email address is not valid

Email is required.

Phone Number

Phone Number is required.

Current Address

Your Facebook Address

Your Instagram Account Name

Are You Eligible to Work in the US?

Yes No

Are You Eligible to Work in the US? is required.

Are you over 18 at this time?

Yes No

Are you over 18 at this time? is required.

Please upload your resume in PDF format

Upload

Please enter your past employment information, beginning with your current or most recent employer.

(1) Employer Name

(1) Employer Name is required.

Employer Phone Number

Employer Phone Number is required.

Employer Address

Position(s) Held

Position(s) Held is required.

Responsibilities

Responsibilities is required.

Employment Start Date

Employment Start Date is required.

Employment End Date

Employment End Date is required.

Starting Pay

$

Starting Pay is required.

Ending Pay

$

Ending Pay is required.

Type

Hourly Salary

Type is required.

Supervisor First Name

Supervisor First Name is required.

Supervisor Last Name

Supervisor Last Name is required.

May we contact your supervisor?

Yes No

May we contact your supervisor? is required.

Reason for leaving?

Reason for leaving? is required.

(2) Employer Name

(2) Employer Name is required.

Employer Phone Number

Employer Phone Number is required.

Employer Address

Position(s) Held

Position(s) Held is required.

Responsibilities

Responsibilities is required.

Employment Start Date

Employment Start Date is required.

Employment End Date

Employment End Date is required.

Starting Pay

$

Starting Pay is required.

Ending Pay

$

Ending Pay is required.

Type

Hourly Salary

Type is required.

Supervisor First Name

Supervisor First Name is required.

Supervisor Last Name

Supervisor Last Name is required.

May we contact your supervisor?

yes no

May we contact your supervisor? is required.

Reason for leaving?

Reason for leaving? is required.

(3) Employer Name

(3) Employer Name is required.

Employer Phone Number

Employer Phone Number is required.

Employer Address

Position(s) Held

Position(s) Held is required.

Responsibilities

Responsibilities is required.

Employment Start Date

Employment Start Date is required.

Employment End Date

Employment End Date is required.

Starting Pay

$

Starting Pay is required.

Ending Pay

$

Ending Pay is required.

Type

Hourly Salary

Type is required.

Supervisor First Name

Supervisor First Name is required.

Supervisor Last Name

Supervisor Last Name is required.

May we contact your supervisor?

yes no

May we contact your supervisor? is required.

Reason for leaving?

Reason for leaving? is required.

Please list two references.

Reference (1) Name

Reference (1) Email

Email address is not valid

Reference (1) Phone

Length of Time Known

Relationship to You

Reference (2) Name

Reference (2) Email

Email address is not valid

Reference (2) Phone

Length of Time Known

Relationship to You

How did you learn about this job opening?

How did you learn about this job opening? is required.

Why are you interested in working here?

Why are you interested in working here? is required.

Is there any reason that would make you unable to perform all physical aspects of the position you are applying for?

Is there any reason that would make you unable to perform all physical aspects of the position you are applying for? is required.

What salary would you need for you and your family to consider this position?

$

What salary would you need for you and your family to consider this position? is required.

What is the minimum number of hours you would like to work per week?

What is the minimum number of hours you would like to work per week? is required.

What is the maximum number of hours you would like to work per week?

What is the maximum number of hours you would like to work per week? is required.

Please tell us about your connection to CrossPoint.

Please tell us about your connection to CrossPoint. is required.

Describe any experiences, education, training, or special skills you have that may be applicable to this position:

Describe any experiences, education, training, or special skills you have that may be applicable to this position: is required.

How would you describe yourself?

How would you describe yourself? is required.

Why does this position interest you?

Why does this position interest you? is required.

Have you ever been fired or otherwise asked to leave a job?

Have you ever been fired or otherwise asked to leave a job? is required.

How many work days, other than planned vacation days, have you missed in the last two years?

How many work days, other than planned vacation days, have you missed in the last two years? is required.

Electronic Signature

Electronic Signature is required.

Today's Date

Today's Date is required.

Submit

Error

620.663.4164

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