Clearwater Company Employment Application

1

Full Name* This field is required.This must be your full legal name. If hired, this name will be used to issue your paycheck and file tax documents.

First Name

Middle Name

Last Name

2

Address* This field is required.This will be the address of record where we will send your paycheck and tax documents if you are hired.

Street Address

Street Address Line 2

City

State

Zip Code

Country

3

Cell Phone Number* This field is required.You will have the opportunity to enter an optional second/home or work phone number where you can be reached, in the next two sections. Be sure to enter a reachable cell, second/home or work number. This will be used for a phone interview and job offer.

4

Second or Home Phone Number

5

Work Phone Number

6

E-Mail* This field is required.Be sure to enter a reachable e-mail. This will be used for submission of required employment documents necessary to hire you and issue a paycheck. Your e-mail will also be used to maintain employment related correspondence with you.

7

Birth Date

8

Gender* This field is required.

Male

Female

N/A

9

Position Applying For* This field is required.You may apply for more than one position. Select one and then select another. You don't necessarily have to immediately qualify. We will train for those who have the motivation, desire, trustworthiness, ability to learn and follow direction.

10

Date You Can Start* This field is required.New hires are assigned to on-demand jobs. Immediate and flexible start dates are desirable.

Date

11

Hourly Rate Desired* This field is required.Provide the hourly rate you are comfortable working for as a starting rate. We quickly increase the hourly rate for those who are top performers and can be trusted. Trustworthy top performers rank high on the list to be called on jobs.

12

Have You Worked Here Before?* This field is required.

Yes

No

13

Have You Applied Here Before?* This field is required.

Yes

No

14

Are You A U.S. Citizen?* This field is required.

Yes

No

15

High School* This field is required.If you did not attend, please say so.

Name of High School Attended

16

Number of Years Attended* This field is required.Put zero if not applicable.

17

Graduated?* This field is required.

YESNO

18

19

College* This field is required.If you did not attend, please say so.

Name of College/University Attended

20

Area of Study/Degree* This field is required.If none, say so.

21

Number of Years Attended* This field is required.Put zero if not applicable.

22

Graduated?* This field is required.

YESNO

23

24

Graduate School* This field is required.If you did not attend, please say so.

Name of Graduate School Attended

25

Area of Study/Degree* This field is required.If none, say so.

26

Number of Years Attended* This field is required.Put zero if not applicable.

27

Graduated?* This field is required.

YESNO

28

29

Trade School/Other

Name of Trade/Technical/Other School Attended

30

Area of Study/Degree

31

Number of Years Attended

32

Graduated?

YESNO

33

SkillsPlease include any skills you feel are valuable for the position(s) applied for.

List any relevant skills

34

QualificationsBriefly describe any qualification that may be useful for the position(s) applied for.

List any relevant certifications or qualifications

35

Current Employer* This field is required.If none, please say so.

Name of Current Employer or NONE if not Employed

36

Position* This field is required.If not applicable, write NA.

37

Hourly Rate* This field is required.If not applicable, enter zero.

38

Reason for Leaving?* This field is required.If not applicable, write NA.

39

Start Date* This field is required.Enter approximate start date. If not applicable, select today's date.

Date

40

Supervisor* This field is required.If not applicable, write NA in both fields.

First Name

Last Name

41

Supervisor or Work Phone Number* This field is required.If not applicable, type in zeros.

42

Supervisor E-Mail

example@example.com

43

May We Contact?* This field is required.

Yes

No

Not Applicable

44

Previous Employer 1* This field is required.If none, please say so.

Name of Previous Employer

45

Position* This field is required.If not applicable, write NA.

46

Hourly Rate* This field is required.If not applicable, enter zero.

47

Reason for Leaving?* This field is required.If not applicable, write NA.

48

Start Date* This field is required.Enter approximate start date. If not applicable, select today's date.

Date

49

End Date* This field is required.Enter approximate end date. If not applicable, select today's date.

Date

50

Supervisor* This field is required.If not applicable, write NA in both fields.

First Name

Last Name

51

Supervisor or Work Phone Number* This field is required.If not applicable, type in zeros.

52

Supervisor E-Mail

example@example.com

53

May We Contact?* This field is required.

Yes

No

Not Applicable

54

Previous Employer 2

Name of Previous Employer

55

Position

56

Hourly Rate

57

Reason for Leaving?

58

Start DateEnter approximate start date.

Date

59

End DateEnter approximate end date.

Date

60

Supervisor

First Name

Last Name

61

Supervisor or Work Phone Number

62

Supervisor E-Mail

example@example.com

63

May We Contact?

Yes

No

64

Previous Employer 3

Name of Previous Employer

65

Position

66

Hourly Rate

67

Reason for Leaving?

68

Start DateEnter approximate start date.

Date

69

End DateEnter approximate end date.

Date

70

Supervisor

First Name

Last Name

71

Supervisor or Work Phone Number

Area Code

Phone Number

72

Supervisor E-Mail

example@example.com

73

May We Contact

YESNO

74

Reference 1

Name of Reference

75

Relationship

76

Years Acquainted

77

Phone

78

E-Mail

79

80

Reference 2

Name of Reference

81

Relationship

82

Years Acquainted

83

Phone Number

84

E-Mail

85

86

Cover LetterProvide a brief introduction of yourself if you like.

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Max. file size: 10.0MB

87

ResumeYour resume should contain an outline of your job experience and education - with specifics such as employer name, dates employed and what you did. For education, you should list the institution name, dates attended and area of study.

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Max. file size: 10.0MB

88

Background Check AuthorizationOn desktop, hover over the top of the application to reveal download/print option. On smartphones, tap top right area near scroll bar to download.

89

Drug / Alcohol Testing Consent FormOn desktop, hover over the top of the application to reveal download/print option. On smartphones, tap top right area near scroll bar to download.

90

Upload Signed FormsYou may upload multiple forms.

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Select files to upload

Max. file size: 10.6MB

91

By signing below and clicking the submit button, I certify that all of the information provided by me on this application is true and complete, and I understand that if any false information, ommissions, or misrepresentations are discovered, my application may be rejected and, if I am employed, my employment may be terminated at any time.

In consideration of my employment, I agree to conform to the company's rules and regulations, and I agree that my employment and compenstation can be terminated, with or without cause, and with or without notice, at any time, at either my or the company's option.

I also understand and agree that the terms and conditions of my employment may be changed, with or without cause, and with or without notice, at any time by the company.

If requested, I agree to a background check and/or drug screening at anytime.

If requested, I agree to completing a non-compete agreement regarding certain confidential and proprietary information and trade secrets relating to the business of Clearwater Company.

92

SignatureUse your mouse, tablet pen or finger to sign.

Clear

93

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