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CCS strives to provide the best service possible with every contact!

We operate in an industry built on trust and expertise. This can only be achieved through communication and experienced support — from the very first contact and into the future.

For specific contacts, get in touch below:

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Call +1 800 741 5985

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Employment Application

All fields with * are required

Applicant Information

Name:*

Last 4 digits from SSN:*

Any other names you worked under?

Address:

Phone Number:

Email:*

Desired Salary:

Position Applied for:

How did you hear about this job?

Tell us the reason you left your previous employment:

Are you authorized to work in the United States?

Have you ever worked for this company?

If so, when?:

Have you ever been convicted of a felony?

If yes, explain:

Please attach a cover letter and resume (PDF file).*


Education

High School:

From Date:

To Date:

Did you graduate?


College:

From Date:

To Date:

Did you graduate?


References

Please list three professional references.

Reference #1


Reference #2


Reference #3


Previous Employment

Need 7 years of employment history. Explain any gaps in employment.

Employment #1

Phone Number:

Employment Start Date:

Employment End Date:

Address:

Job Title:

Start Salary:

End Salary:

Responsibilities:

Supervisor Name:

Supervisor Phone Number:

May we contact your previous employer?


Employment #2

Phone Number:

Employment Start Date:

Employment End Date:

Address:

Job Title:

Start Salary:

End Salary:

Responsibilities:

Supervisor Name:

Supervisor Phone Number:

May we contact your previous employer?


Employment #3

Phone Number:

Employment Start Date:

Employment End Date:

Address:

Job Title:

Start Salary:

End Salary:

Responsibilities:

Supervisor Name:

Supervisor Phone Number:

May we contact your previous employer?


Military Service

Branch:

From Date:

To Date:

Rank at Discharge:

Type of Discharge:

If other than honorable, explain:


Disclaimer and Signature

I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.

Date:*

I Agree:*


Our expert staff delivers a wide variety of quality services and solutions.

In addition to providing perfusion and autotransfusion services, our expert staff is also capable of
providing informatics, data and quality management, point-of-care testing, blood conservation programs,
hardware and inventory management solutions and more.

EXPLORE SOLUTIONS
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