CPAY Application

Date Applied
First Name
Last Name
Zip Code
Mobile Phone
CONSENT TO RECEIVE SMS MESSAGES: You consent to receive SMS messages (including text messages), and telephone calls from us, our representatives, affiliates, or anyone communicating on our behalf at the specific number(s) you have provided to us, with service-related information, questions about your use of the services, and/or account and marketing information.
You certify, warrant, and represent that the telephone number you have provided to us is your contact number and not someone else’s. You represent that you are permitted to receive calls and text messages at the telephone number you have provided to us. You agree to promptly alert us whenever you stop using a telephone number. Even and our agents, representatives, affiliates, and anyone calling on our behalf may use such means of communication described in this section even if you will incur costs to receive such phone messages, text messages, e-mails, or other means.
Standard message and data rates may apply to all SMS messages (including text messages). We may modify or terminate our SMS messaging services from time to time, for any reason, and without notice, including the right to terminate SMS messaging with or without notice, without liability to you. You may opt out at any time by replying "STOP". 
Upload Photo ID
Upload Resume
What city do you live in?
What is your highest level of education?
Are you currently working?
What is your desired hourly pay rate?
Employment History (This is required. If a resume is submitted, please type "resume submitted")
What is your desired job title? (You may select multiple, please only select jobs you are interested in)
Are you looking for temporary, part time, or full time work?
What shift do you prefer to work?
Are you able to pass a background and drug screening?
How will you be commuting to and from work?
How did you hear about us?
Would you like receive future Job Alerts?
Do you know someone seeking employment? Please enter their name and phone number or email address:
I certify that I am a U.S. citizen, permanent resident, or a foreign national with authorization to work in the United States.
AGREEMENT: If the undersigned candidate accepts employment from an employer CPAY Staffing & Recruiting has presented to the candidate, the candidate agrees to notify CPAY Staffing & Recruiting in writing within 48 hours of employment offer. CPAY Staffing & Recruiting shall be compensated for placement fees by the employer. If the employer fails to compensate CPAY Staffing & Recruiting the candidate must terminate employment within 90 days or shall be liable for placement fees.
I hereby certify that this application contains no willful misrepresentation or falsifications and that the information given by me is true and complete to the best of my knowledge and belief.  I am aware that should investigation at any time disclose any such misrepresentation or falsification as to a material fact, my employment will be terminated.  You are hereby authorized to make any investigations regarding personal history.
By signing and submitting this form, you agree to this statement.
Please sign