Health & Safety Coordinator

Job Application

Welcome and let's get started!
Location: Airway Cleaners

Positon: Health & Safety Coordinator
Date

MonthDayYear
Thank you for your interest for the position of Health & Safety Coordinator at Airway Cleaners. The application process will start on the next page. Please click “next” to start.

Personal Information

All information regarding applicant
Name*

First NameMiddle NameLast Name
Date of Birth*

MonthDayYear
Date
Email*
example@example.com
I Authorize Airway to communicate with me via SMS/Text or By Phone*

YesNo
Phone Number
Please enter a valid phone number.
Height*
Weight*
Hair Color*
Eye Color*
Place Of Birth*
Are You a veteran of the US Military?*

YesNo
What is your Preferred Language?*
To Help provide better service our customers, please indicate if you are multilingual.*

YesNo
If Yes, please state list all other languages*
Is this a referral?

YesNo
If Yes, Name of employee and location where they work
Phone Number of employee
Please enter a valid phone number.

EDUCATION
What is your highest level of education?
Name of School/Educational Institution
Major area of study
Degree/Certifications
Skills

Background Information

ATTENTION!!!

List all residences during the last 5 years (begin with the today's date). There should be no gaps. Include all addresses including outside of the United States. Failure to provide accurate information can result in a denial for airport ID.

Add as many addresses as you need to show a total of 5 years.

Examples

First Address:

Street Address	City	State	From	To
123 Flow Ave	Birmingham	WI	01-01-2022	*02-02-2024 (Choose Today's Date)*

Add Another Address:

Street Address	Country	State	From	To
119 Rural Rd	Thailand		05-17-2015	01-01-2022

First address only shows 2 years, second address was added to show remainder of the 3 years residence.

Address*

Work Experience
Are you currently employed?*

YesNo
Are You a current employee of Airway Cleaners?*

YesNo
If Yes, state which location/department you are currently reporting to.
Have you ever been employed at Airway Cleaners?*

YesNo
If Yes, Please state location and department/supervisor.
If Hired, when can you start?*

Attention!!!

Please provide 10 years of employment history (begin with today's date!) List in chronological order, giving most recent employment first. There must be no gaps during 10 year period. Include all experience, even if outside of the United States. IF you were in school, then please state this. If there were gaps or periods where you were not working, please put dates and list as unemployed. Failure to provide accurate information can result in a denial for airport ID.

Add as many work experiences as needed!!!

Examples

Company	Job Title	Start Date	End Date	Responsibilities	Reason For Leaving
Alliance	Buyer	02-01-2023	(Today's Date) 02-02-2024	Purchasing	Currently Employed

+Add Work Experience

Company	Job Title	Start Date	End Date	Responsibilities	Reason For Leaving
None	None	03-02-2020	02-01-2023	None	Unemployed

+Add Work Experience

Company	Job Title	Start Date	End Date	Responsibilities	Reason For Leaving
Hotel	Manager	03-01-2012	03-02-2020	Budget,Hiring,Etc.	Migrated To The USA

Work Experience*

	Unable to Perform
Walking - Up to 8 Hours per shift
Standing - Up to 8 Hours Per Shift
Bending at waist - Up to 6 Hours Per Shift
Climbing steps and stairs - Up to 3 hours Per Shift
Reaching - Up to 6 Hours Per Shift
Bending - Up to 6 Hours Per Shift
Squatting/Kneeling - Up to 6 Hours Per Shift
Sitting - Up to 6 Hours Per Shift
Driving - Up to 8 Hours Per Shift
Repetitive Motions - Up to 8 Hours Per Shift
Lifting - 15 - 20 lbs, up to 8 Hours Per Shift
Heavy Lifting - Up to 50 lbs 2 Hours Per Shift
Twisting/Turning - Up to 6 Hours Per Shift

Voluntary Self Identification – Disablility

We provide reasonable accommodations to individuals with disabilities as needed.
Please select one of the options below:

Yes I have a disability or have a history/record of having a disabilityNo I do not have a disability or a history/record of having a disabilityI Do Not Wish To Answer

AVAILABILITY

Airway connot guarantee any future employee a specific shift. We aim to accommodate with respect to the operation. Please have open availablity as we fill slots where there is a need.
Please indicate if you are seeking Full-time (40 hours), or Part-time (20-25 hours).

Full-timePart-timeOpen Availability
Please select all shifts you are available to work.

MorningsAfternoonsOvernightWeekendsOpen Availability

ADDITIONAL INFORMATION
If hired, can you provide proof that you are legally able to work in the United States?
In compliance with federal law, all persons hired will be required to verify identity and eligibility to work in the US and will need to complete the required employment eligibility document form upon hire.*

YesNo

REFERENCES

Please list one professional reference (name, relationship and phone number). The reference must be current or previous supervisor/manager.
Reference Name

First NameLast Name
Reference Phone Number
Please enter a valid phone number.
Relationship to Reference
Upload Resume or any supporting documents.

Cancelof

Disclaimer
By clicking the submit button, I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for dismissal. I authorize investigation of all statements contained herein and the references and employers 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 the company from all liability for any damage that may result from utilization of such information. I also understand and agree that no representative of the company has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing, unless it is in writing and signed by an authorized company representative. This online application does not permit the release or use of disability-related or medical information in a manner prohibited by the American with Disabilities Act (ADA) and other relevant federal and state laws. Airway Cleaners is an Equal Opportunity Employer.
I have read and agree to the above statement
Should be Empty:

	Yes	No
Forgery Of Certificate, false marking of aircraft and other aircraft registration violations.
Improper Transportation of hazardous materials
Aircraft Piracy
Interference with flight crewmembers or flight attendants
Commission of certain crimes aboard aircraft
Carrying a weapon or explosive aboard aircraft
Conveying false information or threats
Aircraft piracy outside the special aircraft jurisdiction of the United States
Lighting violation involving transportation-controlled substances
Unlawful entry into an aircraft or airport area that serves air carriers or foreign air carriers contrary to established security requirements
Destruction of an aircraft facility
Murder
Assault with intent to murder
Espionage
Sedition
Kidnapping or Hostage Taking
Treason
Rape or Aggravated Sexual Abuse
Unlawful possession, use, sale, distribution or manufature of an explosive or a weapon
Extortion
Armed or Felony unarmed robbery
Distribution of or intent to distribute a controlled substance
Felony Arson
Felonly involving threat
Violence at international airports
Conspiracy or attempt to commit any of the criminal acts listed in this section

	Yes	No
Wilful Destruction of property
Importation or manufacturing of a controlled substance
Burglary
Theft
Dishonesty, fraud or misrepresentation
Possession or distribution of stolen property
Bribery
Illegal possession of a controlled substance
Or any other crimes classified as a felony that the administrator determines indicates a propensity for placing contraband aboard an aircraft for money, violence at international airports, conspiracy to commit any criminal acts.

Job Application

Personal Information

JOB REQUIREMENTS

Additional Information

Airport ID

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