Job Application Form
Please Fill Out the Form Below to Submit Your Job Application!
Name
*
First Name
Middle Name
Last Name
E-mail
*
example@example.com
Phone Number
*
Your Current Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
What Position are you applying for?
*
Cleaning Technician
Supervisor
Carpet Cleaning Technician
Other
Earliest Possible Start Date
-
Month
-
Day
Year
Date
Are you at least 18 years old?
*
yes
no
Are you legally eligible for employment in this country?
*
yes
no
(PROOF OF US CITIZENSHIP OR IMMIGRATION STATUS WILL BE REQUIRED UPON EMPLOYMENT)
Will you work overtime if required?
*
yes
no
How many hours can you work weekly?
Can you work nights?
*
yes
no
Employment Desired
*
FULL-TIME ONLY
PART-TIME ONLY
FULL OR PART-TIME
Education
TYPE OF SCHOOL
High School
College
Business or Trade School
Professional School
Any details you would like to add
Please do not exceed 200 words.
HAVE YOU EVER BEEN CONVICTED OF A FELONY OR MISDEMEANOR?
*
yes
no
DO YOU HAVE A DRIVERS LICENSE?
*
yes
no
What is your means of transportation to work?
*
Please list two references other than relatives or previous employers.
*
Position of Reference
Company
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
2nd Reference (other than relatives or employers)
Company
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Work Experience
Use the space below to summarize any additional information necessary to describe your full qualifications for the specific position for which you are applying.
Name of Employer
*
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Name of last supervisor
Pay or salary
Your last job title
Reason for leaving (be specific)
List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company.
Name of Employer
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Name of supervisor
Your job title
Reason for leaving (be specific)
List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company.
Pay or salary
May we contact your present employer?
*
yes
no
I don't have a current employer
Did you complete this application yourself?
*
yes
no
AGREEMENT (PLEASE READ CAREFULLY BEFORE SIGNING)
I certify that all the information on this application is accurate and complete to the best of my knowledge and understand that misleading or false statements will constitute sufficient cause for refusal of hire or termination of my employment. I understand that neither the acceptance of this application nor the subsequent entry into any type of employment relationship with BLACKBURN BUILDING SERVICES creates an actual or implied contract of employment. I understand that, if I accept employment with BLACKBURN BUILDING SERVICES it will be on an at-will basis. This means that either BLACKBURN BUILDING SERVICES or I have the right to terminate the employment relationship at any time, for any reason, with or without cause. I agree to submit to drug and alcohol testing, and give my consent as required by BLACKBURN BUILDING SERVICES. I authorize and consent BLACKBURN BUILDING SERVICES to investigate information concerning my education, employment experiences and all other aspects of my background relevant to my proposed employment and certify that any information I give/have in this application is true and accurate.
Print your signature (print your name if you agree)
*
First Name
Last Name
BLACKBURN PROFESSIONAL CLEANING, ALSO CALLED BLACKBURN BUILDING SERVICES is an equal employment opportunity employer. We adhere to a policy of making employment decisions without regard to race, color, religion, sex, sexual orientation, national origin, citizenship, age or disability. We assure you that your opportunity for employment with BLACKBURN BUILDING SERVICES depends solely on your qualifications.
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