Miss Green Clean Employment Application

Full Name

First NameMiddle NameLast Name

Phone Number

Area CodePhone Number

Work Phone Number

Cell Phone Number

Tax Identification Number

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Email Address

Preferred Method of contact ( select all that apply)

Do you have any difficulties that may interfere with being to work as scheduled? Please explain

High School Name

Years Attended

Graduated?

Degree / Major

College Name

Years Attended

Graduated?

Degree / Major

Trade or Correspondence School

Years Attended

Graduated?

Degree / Major

Most Recent Employer / Date Started and Ended

Second Previous Employer / Date Started and Ended

Please explain any gaps in employment

Are you familiar with eco-frienly cleaning methods?

Briefly describe your understanding of "green clean" as you understand it.

Housekeeping Experience

Please include any information that may be relevant to your experince.

Relevant Experience

Please list four individuals who are very familiar with your professional work and character who may be contacted. Please include their name, position, and a current phone number

References

In the field below, please respond to each of the following questions:

1. Why do you want to join our team, Miss Green Clean?

Narrative Response

What character traits make you an ideal candidate for this position?

How would you handle an unsatisfied customer?

BACKGROUND INFORMATION

Are you, or have you ever been, listed on a sex offender registry?

Are you, or have you ever been, listed on a child or dependant adult abuse registry?

Have you ever been found guilty, accepted a guilty or Plea, or entered a plea of no-contest for any criminal charge?

Have you ever received a deferred judgment, or in some other way had a guilty plea or conviction removed from your record?

If you answered “yes” to any of the above questions, provide date, incident, specific charge, city/state in which occurred:

Have you ever been asked to resign from a position, or been given the choice of resigning or being terminated from your position?

Have you ever been the subject of an investigation or other formal/informal proceeding that resulted in the termination of your employment or resignation?

Have you ever been the subject of an investigation into wrong doing or other formal/informal proceeding, resulting in disciplinary or criminal action?

Briefly explain any “yes” response(s):

Responding "yes" to any of the previous questions is not an automatic bar to employment. The date of the offense and the relationship between the offense or infraction and the position for which you are applying will be considered.

Are you legally eligible to work in the United States?

Are you able to perform with or without reasonable accommodation, the essential job functions required of the position?

Do you wish to be considered for veteran’s preference?

IF YES, PLEASE FILL OUT NEXT SECTION

Military Duty

Active Duty

(mm / yy)

To

(mm / yy)

Branch

Location of Duty

Rank at Discharge

Type of Discharge

Reserve Duty

(mm / yy)

To

(mm / yy)

Branch

Obligation

Times of Current Training Day

AGREEMENT (Read carefully before signing or submitting electronically)

By my signature:

• I acknowledge that individuals who provide false, inaccurate, or incomplete information in the application form, in an interview, or any other part of the hiring process or who fail to disclose information requested in the application form, in an interview, or any other part of the hiring process will not be eligible for employment, or, if they are hired, they will be subject to termination.

• I acknowledge that to the fullest extent permitted by state and federal law, the Academy will consider all information concerning an applicant or an employee in making hiring, termination, and other employment-related decisions. The term "all information" includes information of any kind (verbal, written, photographic, videographic, etc.) that is accessible in any medium (print, electronic, etc.) from any source.

• I acknowledge that the Owner/Operator will consider public information and other information to which it has lawful access. This may include information that is contained in social networking sites, blogs, and other electronic sites, such as YouTube. If there is information that pertains to me that I believe requires explanation, interpretation, or clarification when it is considered, it is my obligation to communicate this information to the Owner.

• I authorize Miss Green Clean to conduct a complete check regarding my background including, but not limited to, criminal record, child and dependent adult abuse registry screening, and sex offender registry. I agree to prepare and sign any other form necessary to complete a criminal background check. I further authorize all government agencies departments, bureaus, or related entities to release any and all information regarding my criminal history, if any. I agree to immediately notify the employer if I should be convicted of any crime while my application is pending, or during my period of employment, if hired.

• I authorize all current and former employers and references to release all information regarding my professional competence, performance, character, and background. I waive any right I may have against any person contacted as a reference concerning this application.

• I acknowledge that information that is relevant to decisions will be considered regardless of the date on which Miss Green Clean obtains the information and regardless of the date on which the information was first published, created, or made accessible.

• I understand that this application will be considered active for twelve (12) months from the date filed. I further understand that if I am employed by the Miss Green Clean, this application and associated documents will become part of my permanent record.

• I understand that this application is not a contract of employment. In accepting the position, if hired, I understand that employment is at will, unless otherwise specified. I acknowledge that the company may discharge an at-will employee at any time.

Are you currently under contract for any other cleaning company?

By my electronic submission of this form:

• I attest that all the information contained in this application is accurate, complete, and true.

• I am bound by all elements of the agreement section of the application.

• I understand and accept that electronic submission will be considered equivalent to an original hand written signature on a paper copy of the application.

Name

Signature

Date

Applicant Information

Education History

Previous Work Experience

Miss Green Clean Wants to Know...