Employment Application Form

Instructions - Please Read: This is a general employment application required for all jobs. If a job vacancy exists, you may also be asked to complete one or more additional forms in the screening process. Please check your information for accuracy
(especially important information such as telephone numbers). If you need another form or have any questions, please ask.

Name:*

First NameLast Name

Phone Number:*

E-mail Address:*

example@example.com

Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Position and Area you are applying for?*

Do you have reliable transportation?*

If you drive your own vehicle do you have a valid driver's license & auto insurance?*

Are you seeking full-time or part-time employment?*

Part-timeFull-time

Hours per week available:*

Days available*

Work References Please list the last two (2) places that you worked.

Work Reference 1

Company Name*

Phone Number*

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Position*

Reason for Leaving*

Dates of employment*

Work Reference 2

Company Name*

Phone Number*

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Position*

Reason for Leaving*

Dates of employment*

Did you Graduate or GED*

Work References Please list two (2) references (non-family) that are familiar with your work life.

Reference 1

Name:

First NameLast Name

Phone Number

Years Known:

Reference 2

Name:

First NameLast Name

Phone Number

Years Known:

Applications that are not complete and/or questions not fully answered may not be considered for employment. False or misleading information or significant omissions may disqualify the applicant from consideration as well as dismissal if hired.

I hereby affirm that the information provided on this application and accompanying letter or résumé is true and complete. I authorize investigation of all statements contained in this application including contacting past employers regarding my work record. I release and hold harmless and promise not to claim damages from any of my prior employers listed above who have provided information. I understand that misrepresentation or omission of facts called for is cause for dismissal. Further, I understand and agree that my employment is for no definite period and may, regardless of the date of payment of my wages and salary, be terminated at any time without any previous notice. I agree to submit to any drug or alcohol testing that may be required by the employer for my hire or continued employment. I understand that refusal to take such tests may be cause for denial of employment or termination. I understand this application is not a contract.

Signature*

Each Environment Control company is independently owned and operated and firmly endorses the principles of the Equal Employment Opportunity Commission to recruit, hire, and promote the best qualified for all positions without regard to race, national origin, sex, age, religion, or disability.

Please verify that you are human*

Education