California Hand Wash Employment Application

California Hand Wash Employment Application

Complete the applicant, eligibility, job requirements, and employment history sections, then review and certify your information.
Applicant Information
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate of Application
First Name
Last Name
Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Phone
Please enter a valid phone number.Format: (000) 000-0000.
Email

Confirmation Emailexample@example.com
Date Available to Start

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Position(s) Applying For
Location Applying To
Location Email
example@example.com
Availability
Select all that apply
Eligibility Requirements
Are you 18 or older?
Do you have a valid driver's license?
State of Issuance
In the past 24 months, have you had any moving violations, license suspensions, or DUI's?
Are you authorized to work in the US?
Physical Job Requirements

All Positions
Can you lift and carry up to 25 pounds occasionally?
Can you lift and carry up to 50 pounds occasionally?
Can you stand for extended periods of time?
Can you bend as required to perform job duties?
Can you kneel as required to perform job duties?
Can you push or pull equipment or materials as required to perform job duties?
Can you climb stairs or steps as required to perform job duties?
Can you work outdoors in various weather conditions?
Work in confined spaces while performing equipment maintenance and repairs?
Assist with lifting, moving, and positioning equipment weighing 100 pounds or more, including team lifting or using appropriate mechanical equipment?
Work safely around conveyor systems, motors, pumps, and other car wash equipment?
Stand and walk for extended periods while overseeing daily operations and assisting with maintenance and repairs?
If you answered NO to any question above, please identify the job function you are unable to perform:
Felony Conviction Disclosure
In the past 7 years, have you ever been convicted of a felony?
If yes, please explain below, including the nature of the conviction, the date, and any relevant details you wish to provide: *You do not need to disclose records that have been expunged, sealed restricted, or discharged under Georgia's First Offender Act or a conditional discharge.
A conviction does not automatically disqualify an applicant. Any information provided will be evaluated individually, considering the nature of the offense, the time elapsed, and its relevance to the position, in accordance with applicable federal, state, and local laws.
Employment History
Employer 1

Name of EmployerJob Title
Start Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
End Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Reason for Leaving
May we contact this employer?
Employer 1 Contact Name

First NameLast Name
Employer 1 Contact Email
example@example.com
Employer 1 Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Employer 2

Name of EmployerJob Title
Start Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
End Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Reason for Leaving
May we contact this employer?
Employer 2 Contact Name

First NameLast Name
Employer 2 Contact Email
example@example.com
Employer 2 Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Employer 3

Name of EmployerJob Title
Start Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
End Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Employer 3 Reason for Leaving
May we contact this employer?
Employer 3 Contact Name

First NameLast Name
Employer 3 Contact Email
example@example.com
Employer 3 Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Applicant Certification
Certification Statement - By Clicking each statement and signing below I certify that:
Signature
Printed Name

First NameLast Name
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Office Use Only
Interviewer Name

First NameLast Name
Interview Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Position
Location Applying To
For Office Use Only
Additional Notes:
California Hand Wash is an equal opportunity employer and does not discriminate on the basis of race, color, religion, sex, national origin, age, disability, genetic information, veteran status, or any other status protected by law.
Should be Empty:

California Hand Wash Employment Application

Applicant Information

Eligibility Requirements

Physical Job Requirements

Felony Conviction Disclosure

Employment History

Applicant Certification

Office Use Only