BMP Cleaner Contractor Job Application

Employment Application

We are an Equal Opportunity Employer and fully subscribe to the principles of Equal Employment Opportunity. Applicants and/or employees are considered for hire, promotion and job status, without regard to race, color, religion, creed, sex, marital status, national origin, age, physical or mental disability.
Full Legal Name*

First NameMiddle NameLast Name
Phone Number*

Area CodePhone Number
E-mail*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Are you able to perform the essential job functions of the position for which you are applying with or without reasonable accommodation?*

YesNo
Have you ever been convicted of a felony? (This does not automatically exclude you from employment )*

YesNo
If yes, explain
Do you have reliable transportation?*

YesNo
If required, will you work (please check all that apply):*

Rotating ShiftsOvertimeSundaysSaturdays
Education History
High School
High School Name
High School City, State
Years Attended
Focus of Study
Last grade completed*

123456789101112
Graduated

YesNo
College
College Name
Years Attended
Focus of Study
Graduated

YesNo
Other Education/Skills
Please list any other education and/or skills appropriate for the position you are applying for:
Please list any significant experiences, interests, and/or accomplishments you have that may be useful in this position. (Please Note: names and/or organizations designating race, religion, national origin, etc, does not need to be shared.)
Employment History

Please provide the information of your most recent employers in order of the newest to oldest below.
Most Recent Employer Name*
Most Recent Employment Start Date*

MonthDayYear
Most Recent Employment End Date*

MonthDayYear
Most Recent Employer Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Most Recent Employer Phone Number*

Area CodePhone Number
Most Recent Supervisor's Name and Position *
Salary *
Type of Work Performed*
Reason for Leaving, if applicable
May we contact this employer?*

YesNo
Employer Name*
Employment Start Date*

MonthDayYear
Employment End Date*

MonthDayYear
Employer Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Employer Phone Number*

Area CodePhone Number
Salary
Supervisors Name and Position *
Type of Work Performed*
Reason for Leaving*
May we contact this employer?*

YesNo
Employer Name
Employment End Date

MonthDayYear
Employment End Date

MonthDayYear
Employer Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Employer Phone Number

Area CodePhone Number
Salary
Supervisors Name and Position
Type of Work Performed
Reason for Leaving
May we contact this employer?

YesNo
READ CAREFULLY*

I certify that the information contained in this application is correct to the best of my knowledge and understand that any misstatement or omission of information may result in denial of employment or discharge. I authorize the references listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release all parties from all liability for any damage that may result from furnishing same to you.
Should be Empty:

Employment Application

Education History

High School

College

Other Education/Skills

Employment History