1. Personal Information    2. Schedule    3. Experience    4. Finish

*First Name		*Street Address
*Last Name		*City
*Primary Phone		*State	Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
Alternate Phone		*Zip
Email Address
*Select the position you are interested in: Customer Service Tech Support		*Are you at least 16 years of age? Yes No

Have you been convicted of a crime in the last 7 years? Yes No

*Are you willing to undergo a background check and submit to a drug screening for this position?
Yes No

We schedule our workforce within agreed upon availability in order to optimally handle forecasted call volume. All schedules require weekend availability. We are open 24/7 including all holidays.

*How many hours can you be scheduled each week?
Full Time
Part Time

*Our Employees are scheduled in 4 to 8 hour shifts. Please describe your availability below for each weekday. The number of hours scheduled cannot be guaranteed without a range of availability. Please take care to distinguish Preference from actual Availability. (You may enter "Any" to denote full scheduling availability; Please enter "None" if not available for a particular day. Please note AM or PM for all times entered.)

	Earliest Available	Latest Available	Preferred Start	Preferred # Hours Scheduled
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday

Please select the option below which best describes your weekend scheduling preference:
Every Other Weekend
Every Saturday
Every Sunday
Prefer to work all weekends (Saturday and Sunday)

Please check any regularly scheduled activities which might affect your availability:
Other Job
School
Other

What is the highest level of education completed?

High School	4 Year Degree
Some College	Other
2 Year Degree

comments

Please select as many of the options below which may describe you qualification for this position:
Call Center Experience
Customer Service Experience
Inbound Telephone Operator
Outbound Telephone Operator
Consulting and/or Sales
Email or Real Time Chat Support
Technical Support (Help Desk) Experience
Internet Knowledge
Internet Connectivity Trouble Shooting Experience
Systems Administration Knowledge
Systems Administration Experience
Server Maintenance Knowledge
Server Maintenance Knowledge
Team Lead/Supervisor Experience
Training Experience
Bilingual (Language other than English)

Please provide your work history for the past 5 years (or less if newer to the job market). All fields are required for each job listed. List jobs in order from most recent or current. There is a space at the end of this form where you may list additional work history.

*Job Title		*Immediate Supervisor
*Employer		*From Date
Employer Phone		*To Date
*Location	Address City State	*Final Salary
*Description Of Responsibilities		*Reasons For Leaving
*May we contact this employer? Yes No

Please feel free to paste your resume or list additional comments in the field below (this is not required to submit this form):

*When are you available to start?

How did you hear about us? Employee Referral School or Institution Internet Job Site Newspaper Ad Other

*PLEASE READ AND ACKNOWLEDGE THE FOLLOWING BEFORE SUBMITTING YOUR APPLICATION:

1. All applications are subject to Customer Direct's current testing and screening process.
2. You will be required to sign this application in our office validating that all information provided here-- along with additional data required at that time-- is true to the best of your knowledge prior to any job offer being made.
3. All employment with Customer Direct is for no definite period and may, regardless of the date of payment of wages, with or without notice.
4. I am legally eligible for employment in this country.

*I have read and acknowledged the terms listed above.