Thanks for Expressing interest in becoming an employee of CCU. Please make sure that it is as complete as possible, as it will help us to make an informed decision. After you submit your application via email, you will receive an automated reply from our Website to confirm that we received it and depending on job availability you may receive a follow-up telephone call from one of our managers with-in a few days.

Basic Information
First Name:	*
Last Name:	*
Telephone Number:	*
Email Address:
Address:	*
City:	*
State:	*
Zip Code:	*
Social Security Number:	*
You are:	Over 18 years of age. Under 18 years of age.
Conviction History:	No I have never been convicted of any crime. Yes I have been convicted of a crime.
If yes state offense location date and disposition:
Employment Desired
Legally Employable?	I am legally employable in the USA. I am not legally employable in the USA.
Eployment Type Desired:	Full Time Position Part Time Position Temporary or Summer Employment
Position Applied For?
Salary Desired:
Date available to start:
Applied or Worked here Before?	No I have never applied to this company before. Yes I have applied to this company but never been hired.  Yes I have been hired by this company before.
If yes please describe your experience.
How did you learn about our Company:
Currently Employed?	Yes I am currently employed elsewhere.  No I am not currently employed.
Travel/Work Overtime	Yes I am able to Travel/Work Overtime. No I have restrictions on my ability to Travel/Work Overtime.
My ability to Travel/Work Overtime is restricted by:
Dates/Times You will be Unavailable to work:
Education
High School:
Level of Completion:	Graduated Currently Attending Partially Completed
Year(s) attended/Year of Graduation
College:
Major(s)/Minor(s)
Level of Completion:	N/A Partially Completed Still Attending Bachelor's Degree Master's Degree PHD
Year(s) attended/ Year of Graduation
Trade School:
Selection List	N/A Partially Completed Program Still Attending Program Graduated
Area of Concentration:
Year(s) attended/Year of Graduation
If Applicable why did you stop attending school?
Scholastic Honors/ Offices Held/ Activities:
Other Special Skills or Training:
Future Plans for Education:
Military Service
Military	No I have not served in the Military. Yes I have served in the Military.
Branch of Service:
Dates/Years of Service:
Final Rank:
Special Skills
I can type:	0 words per minute. 1-19 words per minute. 20-30 words per minute 40-50 words per minute. 50-60 words per minute. more than 60 words per minute.
I have:	No experience using a Computer.  Very little experience using a computer. Moderate experience using a computer. Advanced experience using a computer.
Programs you comfortable/proficient with.
What is your first language?	English Spanish French German Other
Other languages you speak fluently?
Other Noteworthy Skills:
Work History
Name of Employer:
Address :
City
State:
Zipcode:
Telephone (000)000-0000
Nature of Business:
Title & Job Description:
Date Employed: 00/00/00 to 00/00/00
Name of Last Supervisor:
Reason for Leaving:
Name of Employer:
Address:
Telephone (000)000-0000
Nature of Business:
Title & Job Description:
Date Employed: 00/00/00 to 00/00/00
Name of Last Supervisor:
Reason for Leaving:
Name of Employer:
Address:
City:
State:
Zipcode:
Telephone: (000)000-0000
Nature of Business:
Title & Job Description:
Dates Employed: 00/00/00 to 00/00/00
Name of Last Supervisor:
Reason for Leaving:
Name of Employer:
Address:
City:
State:
Zipcode:
Telephone: (000)000-0000
Nature of Business:
Title & Job Description:
Dates Employed: 00/00/00 to 00/00/00
Name of Last Supervisor:
Reason for Leaving:
Personal References:
Name:
Address:
Telephone: (000)000-0000
Occupation:
Name:
Address:
Telephone: (000)000-0000
Occupation:
Name:
Address:
Telephone: (000)000-0000
Occupation: