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Employment Application

    Personal Information


    Job Interest

    Briefly describe the type of work for which you are best qualified. Note any details about your qualifications that should be considered. Include special skills such as machines operated licenses, foreign languages, computer skills, etc. Note any Technical Training received:

    License I have a valid MA Driver’s License

    I have a valid CDL License Class AClass B

    OHSA I have a valid OHSA 10 or 30 certification

    Hoisting I have a valid MA Hoisting License

    CPR-first-aid My CPR and first aid training is current

    OSHA forklift I have been OSHA trained for forklift operations



    List schools attended, starting with the most recent. (To be employed at CIC you must have a High School Diploma or GED)




    Previous Employer

    Massachusetts General Laws. 149 s 19B requires the following statement be included on employment applications: It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.