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Cornerstone Services has been serving the North Country for over 15 years. We are a thriving local company that cares deeply for our employees and customers. Want to join the team? Fill out our application below!

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First Name

Last Name

Phone

Street Address

Street Address Line 2

City

Region/State/Province

Email

Postal / Zip code

How long have you lived at your current address?

Position Applied For:

How many hours can you work weekly?

Can you work nights?

Yes

No

Can you work weekends?

Yes

No

What days are you available?

No preference

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

Desired Salary

Date of Birth

Proposed Start Date:

Social Security Number

Have you ever been convicted of a crime?

Yes

No

If yes, please explain number of conviction(s), nature of offense leading to conviction, how recently offenses were committed, sentence imposed, and type of rehabilitation.

Do you have a valid driver's license?

Yes

No

Please input driver's license number, state of issue, class, and expiration date.

Have you had any accidents in the past three years?

Yes

No

Have you had any moving violations in the past three years?

Yes

No

High School

How many years completed?

Did you graduate?

College

How many years completed?

Did you graduate?

Business or Trade School

How many years completed?

Did you complete the program?

Please list two references, other than relatives or previous employers

An application form sometimes makes it difficult for an individual to adequately summarize a complete background. Use the space below to summarize any additional information necessary to describe your full qualifications for the specific position for which you are applying:

Have you ever been in the Armed Forces?

Yes

No

Are you now a member of the National guard?

Yes

No

Specialty, Date Entered, and Discharge Date:

Please list your work experience for the past five years, beginning with your most recent job held. If you were self-employed, give the name of the company.

Name of Employer:

Your last job title:

Supervisor

Employment dates:

Street Address

Street Address Line 2

City

Region/State/Province

Postal / Zip code

Country

Pay or Salary:

Reason for leaving:

List the jobs you held, duties performed, skills used or learned, advancements or promotions during your tenure:

Name of Employer:

Your last job title:

Supervisor

Employment dates:

Street Address

Street Address Line 2

City

Region/State/Province

Postal / Zip code

Country

Pay or Salary:

Reason for leaving:

List the jobs you held, duties performed, skills used or learned, advancements or promotions during your tenure:

Name of Employer:

Supervisor

Your last job title:

Employment dates:

Street Address

Street Address Line 2

City

Region/State/Province

Postal / Zip code

Country

Pay or Salary:

Reason for leaving:

List the jobs you held, duties performed, skills used or learned, advancements or promotions during your tenure:

If you have other former employers in the past five years, please include their information below:

May we contact your present employer?:

Yes

No

Did you complete this application yourself?

Yes

No

If not, who completed the application on your behalf?

Is there anything else you would like to share that would help us in processing your application?

Thank you! We’ll be in touch.

32 South Main St

Norwood NY 13668

(315) 353-4515

St. Lawrence County Service Area

60 John Munn Rd

Saranac Lake NY 12983

(315) 483-4800

7 Main St

Ogdensburg NY 13669

(315) 353-4515

Malone Service Area

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315-353-4515

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