Employment Application To apply for a leather repair employment position, fill out the form below or download and print out the Employment Application (PDF) and then submit via mail, email or fax it into us! CCI Employment App-HQ 1 Step 12 Step 23 Step 34 Step 4 APPLICATION FOR EMPLOYMENTWe are an equal opportunity employer and do not unlawfully discriminate in employment. No question on this application is used for the purpose of limiting or excluding any applicant from consideration for employment on a basis prohibited by local, state, or federal law. Equal access to employment, services, and programs is available to all persons. Those applicants requiring reasonable accommodation to the application and/or interview process should notify a representative of the organization.Applicant name:*Date: Position(s) applied for or type of work desired:*Address* Street Address City State / Province / Region ZIP / Postal Code Telephone #:*How did you hear about us?*Please Select BelowHome Magazine AdPrint AdInternet Search-GoogleInternet Search-BingInternet Search-OtherDealership ReferralFurniture Store ReferralReferred by FriendReferred by CustomerReferred by EmployeeSaw Our VanSuperpages AdYellow Page AdOther (please enter below)ReferralPlease let us know from whom or where your referral from above came.Email Address:* City and State to which you're applyingSee our location list here to determine your closest city.Date available to start work: Date available to start work:* Full-time Part-time Temporary Are you able to meet the attendance requirements?*YesNoDo you have any objection to working overtime if necessary?*YesNoCan you travel if required by this position?*YesNoHave you ever been previously employed by our organization?*YesNoCan you submit proof of legal employment authorization and identity?*YesNoHave you had any traffic violations in the last 3 years?*YesNoAre you color blind?YesNoHave you ever been convicted of a crime in the last 7 years?*YesNoIf yes, please explain (a conviction will not automatically bar employment):Drivers license number (if driving is an essential job duty, information is needed for background check)*Date of Birth* How were you referred to us? Employment HistoryPlease provide all employment information for your past four employers starting with the most recent.Employer:Position held:Address:Telephone #:Immediate supervisor and title:Dates employed: from Dates employed: to Salary:Job summary:Reason for leaving:Employer:Position held:Address:Telephone #:Immediate supervisor and title:Dates employed: from Dates employed: to Salary:Job summary:Reason for leaving:Employer:Position held:Address:Telephone #:Immediate supervisor and title:Dates employed: from Dates employed: to Salary:Job summary:Reason for leaving:Employer:Position held:Address:Telephone #:Immediate supervisor and title:Dates employed: from Dates employed: to Salary:Job summary:Reason for leaving: Other Skills and QualificationsSummarize any job-related training, skills, licenses, certificates, and/or other qualifications:Educational HistoryList school name and location, years completed, course of study, and any degrees earned:High school:College:Technical Training:Other: ReferencesList 3 references names, telephone numbers, and years known (do not include relatives or employers):Reference 1:Reference 2:Reference 3:I hereby authorize the potential employer to contact, obtain, and verify the accuracy of information contained in this application from all previous employers, educational institutions, and references. I also hereby release from liability the potential employer and its representatives for seeking, gathering, and using such information to make employment decisions and all other persons or organizations for providing such information. I understand that any misrepresentation or material omission made by me on this application will be sufficient cause for cancellation of this application or immediate termination of employment if I am employed, whenever it may be discovered. If I am employed, I acknowledge that there is no specified length of employment and that this application does not constitute an agreement or contract for employment. Accordingly, either I or the employer can terminate the relationship at will, with or without cause, at any time, so long as there is no violation of applicable federal or state law. I understand that it is the policy of this organization not to refuse to hire or otherwise discriminate against a qualified individual with a disability because of that persons need for a reasonable accommodation as required by the ADA. I also understand that if I am employed, I will be required to provide satisfactory proof of identity and legal work authorization within three days of being hired. Failure to submit such proof within the required time shall result in immediate termination of employment. I represent and warrant that I have read and fully understand the foregoing, and that I seek employment under these conditions.Applicant signature:Date: Please fill out the employment application in its entirety and submit below for processing. Thank you! CREATIVE COLORS INTERNATIONAL, INC Attn: Human Resources 19015 S. Jodi Road Suite E Mokena, IL 60448 Toll Free: 800-933-2656 Fax: 708-478-1636 NameThis field is for validation purposes and should be left unchanged. 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