CTA / Loadmax Application

Thank you for your interest in joining our team, we are excited to hear about what you can contribute to our team.

* Required

First Name *

Last Name

Address

City, State ZIP

Residence Duration How long at current address?

Phone What is the best number to reach you at?

Days Available What days of the week are you available to work?

Hours Available How many hours are you available per week?

Education Level What is the highest educational level achieved?

Felony * Have you ever been convicted of a felony?

Last Company Company Name

Last Company Pay / Salary Pay Period, Pay Amount

Last Supervisor Name of Supervisor

Last Supervisor Phone # Phone #

Last Company Date Started Date Started

Last Company Date Ended Date Ended

Last Company Title/Responsibilities Title & Responsibilities

Last Company Reason for Leaving Reason for Leaving

Last Company Contact May we contact this employer?

Previous Company Company Name

Previous Company Pay / Salary Pay Period, Pay Amount

Previous Company Date Started Date Started

Previous Company Date Ended Date Ended

Previous Supervisor Phone # Phone #

Previous Company Title/Responsibilities Title & Responsibilities

Previous Company Reason for Leaving Reason for Leaving

Previous Company Contact May we contact this employer?

Reference Name 1 Name of Reference

Reference Relationship 1 How is this reference related to you?

Reference Phone 1 Best Contact #?

Reference Years 1 How many years or months have you known this person?

Reference Name 2 Name of Reference

Reference Relationship 2 How is this reference related to you?

Reference Phone 2 Best Contact #?

Reference Years 2 How many years or months have you known this person?

Comments Is there any other information you can provide to assist us in considering your application?