CMS Application for Employment

Equal access to programs, services, and employment is available to all persons. Those applicants requiring reasonable accommodation to the application and/or interview process should notify a representative of the Human Resources Department.

Have you entered into an agreement with any former employer or other party (such as a non-compete agreement) that might, in any way, restrict your ability to work for our company?

This question is not designed to elicit information about an applicant's disability. Please do not provide information about the existence of a disability, particular accommodation, or whether accommodation is necessary. These issues may be addressed at a later stage to the extent permitted by law.

Skills and Qualifications

Voluntary: Confidential (ADA Compliant) Affirmative Action Survey

Choosing not to provide this information does not disqualify your application from consideration for employment.


List names and telephone numbers of two business / work references who are not related to you and are not previous supervisors. If not applicable, list two school or personal references who are not related to you.

Employment History:

Starting with your most recent employer, please provide the following information:

Educational Background:

Starting with your most recent school attended, provide the following information:

Applicant Statement:

I certify that all information I have provided is true and accurate. I understand that any information provided by me that is found to be false, incomplete, or misrepresented in any respect, will be sufficient cause to a) eliminate me from further consideration for employment, or b) may result in my immediate discharge from the employer's service, whenever it is discovered. I expressly authorize, without reservation, the employer, its representatives, employees, or agents to contact and obtain information from all references, employers, public agencies, licensing authorities, and educational institutions and to otherwise verify the accuracy of all information provided by me in this application, resume, or job interview. I hereby waive any and all rights and claims I may have regarding the employer, its agents, employees or representatives, for seeking, gathering, and using truthful and non-defamatory information, in a lawful manner, in the employment process and all other persons, corporations, or organizations for furnishing such information about me. I understand that this employer does not unlawfully discriminate in employment and no question on this application is used for the purpose of limiting or eliminating any applicant from consideration for employment on any basis prohibited by applicable local, state, or Federal law. This application does not constitute an agreement or contract for employment for any specified period or definite duration. I also understand that if I am hired, I will be required to provide proof of identity and legal authorization to work in the United States and that Federal immigration laws require me to complete an I-9 Form in this regard. CMS does not tolerate unlawful discrimination in its employment practices. No question on this application is used for the purpose of limiting or excluding an applicant from consideration for employment on the basis of his or her sex, race, color, religion, national origin, citizenship, age, disability, or any other protected status.