Application for Employment
Name
*
First Name
Middle Name
Last Name
Email
*
example@example.com
Phone Number
*
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Are you a United States Citizen?
*
YES
NO
Have you ever been convicted of a Felony?
*
YES
NO
If selected for employment, are you willing to submit to a Pre-Employment drug screening & background check?
*
YES
NO
Transportation to work:
I have a reliable vehicle for use to get to the first job and personally drive between my scheduled jobs.
I only have the ability to arrive at first job, but need a ride between scheduled jobs each day.
Other
Position you are applying for:
Cleaning Technician
Cleaning Supervisor
Office Staff
Type of Employment Desired
Seasonal / Temporary / Short Term
Part Time
Full Time
How soon can you start if selected for employment?
*
/
Month
/
Day
Year
Date
Preferred Shift(s): Only select shifts that you could work permanently and consistently.
Day Shift (Typically 830am-430PM)
Evening Shift (Typically 4PM-10PM)
Blended Shift (Typically 11am-7PM)
Other
Work Availability
*
Availability
Monday
Day Shift
Evening Shift
Blended Shift
Not Available
Other
Tuesday
Day Shift
Evening Shift
Blended Shift
Not Available
Other
Wednesday
Day Shift
Evening Shift
Blended Shift
Not Available
Other
Thursday
Day Shift
Evening Shift
Blended Shift
Not Available
Other
Friday
Day Shift
Evening Shift
Blended Shift
Not Available
Other
Saturday
Day Shift
Evening Shift
Blended Shift
Not Available
Other
Sunday
Day Shift
Evening Shift
Blended Shift
Not Available
Other
Employment History
*
Employer
Job Title
Start Month & Year
Total # Months
Employed
Phone#
Most Recent
Job #2
Job #3
References
Name
Title
Phone
Email
Reference 1
Reference 2
Reference 3
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.
*
SIGNATURE
Submit
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