Employment Application Form

The Arthur Jackson Company - 7025 West Chester Pike - Upper Darby, PA 19082
Employment Application

Fill the form below accurately indicating your potentials and suitability to job applying for.
All applications are processed through the corporate office listed above. Applications are accepted Monday+ Wednesday+ Friday 9:00 AM to 12:00 PM and 2:00 PM to 4:00 PM.

IF YOU HAVE BEEN SELECTED, WE WILL CONTACT YOU FOR AN INTERVIEW

All applications stay on file for 90 days and are reviewed weekly. The corporate office does not make hiring decisions. Employment is contingent on passing a background check.

Below is a brief description of positions we are currently hiring for:

General Cleaner

Responsibilities include but are NOT limited to the following: vacuum carpeted areas and check for: spot cleaning as needed, dusting and damp wiping of surfaces with regular frequency, walls and doors spot cleaned, hallways and/or stairwells dust mopped and damp mopped. High (around door frames corners, picture frames, window frames, cubicles, partitions, etc.) and low (under chairs, baseboards, in corners, etc.) dusting, Waste paper baskets, trashcans are to be emptied daily and liners changed when needed. Other duties as needed.

Restroom Cleaner

Responsibilities include but are NOT limited to: emptying trash receptacles, refilling supplies, (i.e., soap, paper towels, toilet paper, etc.), all wash basins, dispensers, fixtures and mirrors will be wiped and scrubbed. All toilets and urinals will be disinfected daily. Floors are swept and mopped to meet specifications. Other duties as needed.
EMPLOYMENT APPLICATION
Name : *

First Middle Last
E-mail Address : *
Please provide an email address where we may confirm that we received your application.
Address : *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Home Phone : *

Area Code Phone Number
Mobile :

Area Code Phone Number
If you are hired, can you verify your eligibility to work in the United States? *

Yes No
Date Available for Work : *

Month Day Year
Date
Desired Schedule / Availability : *

Day Full Time Evening Part Time Weekends
Salary Requirements :

Employment Experience

Start with your most recent job. Please include military service and explain any breaks in employment.
Employer Name :
Employers Phone Number :

Area Code Phone Number
Employer Address :

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Job Title :
Start Date :

Month Day Year
Start Date
End Date :

Month Day Year
End Date
Supervisor Name :
Reason for Separation :
Duties / Responsibilities :
Employer Name :
Employers Phone Number :

Area Code Phone Number
Employer Address :

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Job Title :
Start Date :

Month Day Year
Start Date
End Date :

Month Day Year
End Date
Supervisor Name :
Reason for Separation :
Duties / Responsibilities :
Employer Name :
Employers Phone Number :

Area Code Phone Number
Employer Address :

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Job Title :
Start Date :

Month Day Year
Start Date
End Date :

Month Day Year
End Date
Supervisor Name :
Reason for Separation :
Duties / Responsibilities :
I certify that all information on this application is true as it is stated and I authorize The Arthur Jackson Company to verify any detail of this application. I fully understand that falsification of any portion of this application is grounds for immediate termination of employment.
Signature : *

Clear
Date :

Month Day Year
Date

Applicant Questionnaire
Please provide a phone number you can be reached between 9am - 5pm , M - F. *

Area Code Phone Number
Do you have a valid driver's license? Only answer if applying for a driver role.

Yes No
List availability of shifts :

First Shift Second Shift Third Shift
Please list any hours you cannot work :
How or by whom were you referred? (Please select one and fill in name if applicable).
Which position are you applying for?
May we contact your current / past employer(s)?

As a condition of employment with The Arthur Jackson Company, I understand that a criminal background check and/or driver's license check (driver's positions only), will be completed.

I understand that there will be a payroll deduction of $30.00, made in two installments of $15.00 each for this purpose.

Please Note: If you have been selected for a position with The Arthur Jackson Company, we will be contacting you with further instructions and/or information. Thank you for seeking employment with The Arthur Jackson Company.

The Arthur Jackson Company provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.
Birth Date :

Month Day Year
Applicant Signature : *

Clear

BACKGROUND CHECK DISCLOSURE
The Arthur Jackson Company (Legal Company Name of company placing order and using report), and its parents, subsidiaries, and affiliates (the "Company") may order a "consumer report" (a background report) on you in connection with your employment application, and if you are hired, or if you already work for the Company, may order additional background reports on you for employment purposes. The background report may contain information concerning your character, general reputation, personal characteristics, mode of living, drug and alcohol test results, driving records, and criminal history. 

Information may be obtained from private and public record sources.
Applicant :

First Name Middle Name Last Name
Signature : *

Clear
Date :

Month Day Year
Date

BACKGROUND CHECK AUTHORIZATION
BACKGROUND CHECK AUTHORIZATION
I authorize The Arthur Jackson Company (Legal Company Name of company placing order and using report), and its parents, subsidiaries and affiliates ("the Company") to order my background check and/or consumer report, hereafter referred to as "background check". I understand that, as allowed by law, the Company may rely on this authorization to order additional background reports without asking me for my authorization again (1) during my employment, and (2) from any consumer reporting agency ("CRA"). To the extent allowed by law, I also authorize all of the following to disclose to the CRA and its agents all information about or concerning me, including but not limited to: my past or present employers; learning institutions, including colleges and universities; law enforcement and all other federal, state and local agencies; federal, state and local courts; the military; credit bureaus; testing facilities; motor vehicle records agencies; and any other person, organization, or agency with any information about or concerning me as the law otherwise allows. The information that can be disclosed to the CRA and its agents includes, but is not limited to, information concerning my employment and earnings history, education, credit history, motor vehicle history, criminal history, military service, professional credentials and licenses, to the extent allowed by law. Additional information about your rights has been provided to you with this Background Check Authorization. Please review it BEFORE you sign.
Applicant :

First Name Middle Name Last Name
Alias or Other Name Used :
Social Security # :
Date of Birth (for ID purposes only) :

Month Day Year
Date
Driver's License Number :
State of Issue :
Present Address :

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Phone Number :

Area Code Phone Number
Signature : *

Clear
Date :

Month Day Year
Date

STATE NOTICE PERTAINING TO BACKGROUND CHECKS

If you live or work for the Company in any of the states listed below, please note the following:

If you live or work for the Company in California, Minnesota or Oklahoma: Check this box if you would like a free copy of your background report:

□ CALIFORNIA: You have a right to view the file that the CRA has with your information, and order a copy of the file, upon submitting proper identification (such as a valid driver's license, Social Security account number, military identification card or credit card) and paying actual copying costs, by coming to their offices, during normal business hours and on reasonable notice. You also have a right to submit a written request, to include proper identification, for a copy of your file to be sent by certified mail or for a telephonic file summary. The CRA will provide trained personnel to explain to you the information furnished and can answer questions about information in your file including any coded information. If you come to their offices in person, another person can join you, so long as that person can show proper identification. More specific information is set out below.

The CRA, CSS, Inc., will prepare the background report for the Company. The CRA is located at 20 E Clementon Road, Suite 201-S, Gibbsboro, NJ 08026, and can be reached at 866.427.7837. Its website is http://csscheck360.com, and its privacy policies can be found at its website: http://csscheck360.com/privacy-policy.html.

MASSACHUSETTS: If you contact the Company's Human Resources department, you have the right to know whether the Company ordered an investigative consumer report about you. You also have the right to ask the CRA for a copy of any such report.

MINNESOTA: You have the right in most circumstances to submit a written request to the CRA for a complete and accurate disclosure of the nature and scope of any consumer report the Company ordered about you. The CRA must provide you with this disclosure within five business days after its receipt of your request or the report was requested by the Company, whichever date is later.

NEW JERSEY: You have the right to submit a request to the CRA for a copy of any investigative consumer report the Company ordered about you.

NEW YORK: If you contact the Company's Human Resources department, you have the right to know whether the Company ordered a consumer report or investigative consumer report about you. Shown above is the CRA's address and telephone number. You have the right to contact the CRA to inspect or receive a copy of any such report. A copy of Article 23-A of the Correction Law is provided below.

WASHINGTON STATE: If you submit a written request to the Company’s Human Resources department, you have the right to a complete and accurate disclosure of the nature and scope of any investigative consumer report the Company ordered about you. You are entitled to this disclosure within five business days after the date your request is received or we ordered the report, whichever is later. You also have the right to request a written summary of your rights under the Washington Fair Credit Reporting Act. Para información en español, visite www.consumerfinance.gov/learnmore o escribe a la Consumer Financial Protection Bureau, 1700 G Street N.W., Washington, D.C. 20552.

A Summary of Your Rights Under the Fair Credit Reporting Act

The federal Fair Credit Reporting Act(FCRA) promotes the accuracy,fairness,andprivacyofinformation in the files of consumer reporting agencies. There are many types of consumer reporting agencies, including credit bureaus and specialty agencies (such as agencies that sell information about check writing histories, medical records, and rental history records). Here is a summary of your major rights under the FCRA. For more information, including information about additional rights, go to www.consumerfinance.gov/learnmoreorwrite to:Consumer Financial Protection Bureau, 1700 G Street N.W., Washington, DC20552.

• You must be told if information in your file has been used against you. Anyone who uses a credit report or another type of consumer report to deny your application for credit, insurance, or employment- or to take another adverse action against you - must tell you, and must give you the name, address, and phone number of the agency that provided the information.

• You have the right to know what is in your file. You may request and obtain all the information about you in the files of a consumer reporting agency (your "file disclosure"). You will be required to provide proper identification, which may include your Social Security number. In many cases, the disclosure will be free. You are entitled to a free file disclosure if:
- a person has taken adverse action against you because of information in your credit report;
- you are the victim of identity theft and place a fraud alert in your file;
- your file contains inaccurate information as a result of fraud;
- you are on public assistance;
- you are unemployed but expect to apply for employment within 60 days. In addition, all consumers are entitled to one free disclosure every 12 months upon request from each nationwide credit bureau andfrom nationwide specialty consumer reporting agencies. See www.consumerfinance.gov/learnmore for additional information.
• You have the right to ask for a credit score. Credit scores are numerical summaries of your creditworthiness based on information from credit bureaus. You may request a credit score from consumer reporting agencies that create scores or distribute scores used in residential real property loans, but you will have to pay for it. In some mortgage transactions, you will receive credit score information for free from the mortgage lender.

• You have the right to dispute incomplete or inaccurate information. If you identify information in your file that is incomplete or inaccurate, and report it to the consumer reporting agency, the agency must investigate unless your dispute is frivolous. See www.consumerfinance.gov/learnmore for an explanation of dispute procedures.

• Consumer reporting agencies must correct or delete inaccurate, incomplete, or unverifiable information. Inaccurate, incomplete or unverifiable information must be removed or corrected, usually within 30 days. However, a consumer reporting agency may continue to report information it has verified as accurate.

• Consumer reporting agencies may not report outdated negative information. In most cases, a consumer reporting agency may not report negative information that is more than seven years old, or bankruptcies that are more than 10 years old.

• Access to your file is limited. A consumer reporting agency may provide information about you only to people with a valid need -- usually to consider an application with a creditor, insurer, employer, landlord, or other business. The FCRA specifies those with a valid need for access.

• You must give your consent for reports to be provided to employers. A consumer reporting agency may not give out information about you to your employer, or a potential employer, without your written consent given to the employer. Written consent generally is not required in the trucking industry. For more information, go to www.consumerfinance.gov/learnmore.

• You may limit "prescreened" offers of credit and insurance you get based on information in your credit report. Unsolicited "prescreened" offers for credit and insurance must include a toll-free phone number you can call if you choose to remove your name and address from the lists these offers are based on. You may opt out with the nationwide credit bureaus at 1-888-5-0PTOUT (1-888-567-8688).

• You may seek damages from violators. If a consumer reporting agency, or, in some cases, a user of consumer reports or a furnisher of information to a consumer reporting agency violates the FCRA, you may be able to sue in state or federal court.

• Identity theft victims and active duty military personnel have additional rights. For more information, visit www.consumerfinance.gov/learnmore.

States may enforce the FCRA, and many states have their own consumer reporting laws. In some cases, you may have more rights under state law. For more information, contact your state or local consumer protection agency or your state Attorney General.
State Notice
STATE NOTICE PERTAINING TO BACKGROUND CHECKS
If you live or work for the Company in any of the states listed below, please note the following:
If you live or work for the Company in California, Minnesota or Oklahoma: Check this box if you would like a free copy of your background report:
□ CALIFORNIA: You have a right to view the file that the CRA has with your information, and order a copy of the file, upon submitting proper identification (such as a valid driver's license, Social Security account number, military identification card or credit card) and paying actual copying costs, by coming to their offices, during normal business hours and on reasonable notice. You also have a right to submit a written request, to include proper identification, for a copy of your file to be sent by certified mail or for a telephonic file summary. The CRA will provide trained personnel to explain to you the information furnished and can answer questions about information in your file including any coded information. If you come to their offices in person, another person can join you, so long as that person can show proper identification. More specific information is set out below.
The CRA, CSS, Inc., will prepare the background report for the Company. The CRA is located at 20 E Clementon Road, Suite 201-S, Gibbsboro, NJ 08026, and can be reached at 866.427.7837. Its website is http://csscheck360.com, and its privacy policies can be found at its website: http://csscheck360.com/privacy-policy.html.
MASSACHUSETTS: If you contact the Company's Human Resources department, you have the right to know whether the Company ordered an investigative consumer report about you. You also have the right to ask the CRA for a copy of any such report.
MINNESOTA: You have the right in most circumstances to submit a written request to the CRA for a complete and accurate disclosure of the nature and scope of any consumer report the Company ordered about you. The CRA must provide you with this disclosure within five business days after its receipt of your request or the report was requested by the Company, whichever date is later.
NEW JERSEY: You have the right to submit a request to the CRA for a copy of any investigative consumer report the Company ordered about you.
NEW YORK: If you contact the Company's Human Resources department, you have the right to know whether the Company ordered a consumer report or investigative consumer report about you. Shown above is the CRA's address and telephone number. You have the right to contact the CRA to inspect or receive a copy of any such report. A copy of Article 23-A of the Correction Law is provided below.
WASHINGTON STATE: If you submit a written request to the Company’s Human Resources department, you have the right to a complete and accurate disclosure of the nature and scope of any investigative consumer report the Company ordered about you. You are entitled to this disclosure within five business days after the date your request is received or we ordered the report, whichever is later. You also have the right to request a written summary of your rights under the Washington Fair Credit Reporting Act. Para información en español, visite www.consumerfinance.gov/learnmore o escribe a la Consumer Financial Protection Bureau, 1700 G Street N.W., Washington, D.C. 20552.
A Summary of Your Rights Under the Fair Credit Reporting Act
The federal Fair Credit Reporting Act(FCRA) promotes the accuracy,fairness,andprivacyofinformation in the files of consumer reporting agencies. There are many types of consumer reporting agencies, including credit bureaus and specialty agencies (such as agencies that sell information about check writing histories, medical records, and rental history records). Here is a summary of your major rights under the FCRA. For more information, including information about additional rights, go to www.consumerfinance.gov/learnmoreorwrite to:Consumer Financial Protection Bureau, 1700 G Street N.W., Washington, DC20552.
• You must be told if information in your file has been used against you. Anyone who uses a credit report or another type of consumer report to deny your application for credit, insurance, or employment- or to take another adverse action against you - must tell you, and must give you the name, address, and phone number of the agency that provided the information.
• You have the right to know what is in your file. You may request and obtain all the information about you in the files of a consumer reporting agency (your "file disclosure"). You will be required to provide proper identification, which may include your Social Security number. In many cases, the disclosure will be free. You are entitled to a free file disclosure if:
a person has taken adverse action against you because of information in your credit report;
you are the victim of identity theft and place a fraud alert in your file;
your file contains inaccurate information as a result of fraud;
you are on public assistance;
you are unemployed but expect to apply for employment within 60 days. In addition, all consumers are entitled to one free disclosure every 12 months upon request from each nationwide credit bureau andfrom nationwide specialty consumer reporting agencies. See www.consumerfinance.gov/learnmore for additional information.
• You have the right to ask for a credit score. Credit scores are numerical summaries of your creditworthiness based on information from credit bureaus. You may request a credit score from consumer reporting agencies that create scores or distribute scores used in residential real property loans, but you will have to pay for it. In some mortgage transactions, you will receive credit score information for free from the mortgage lender.
• You have the right to dispute incomplete or inaccurate information. If you identify information in your file that is incomplete or inaccurate, and report it to the consumer reporting agency, the agency must investigate unless your dispute is frivolous. See www.consumerfinance.gov/learnmore for an explanation of dispute procedures.
• Consumer reporting agencies must correct or delete inaccurate, incomplete, or unverifiable information. Inaccurate, incomplete or unverifiable information must be removed or corrected, usually within 30 days. However, a consumer reporting agency may continue to report information it has verified as accurate.
• Consumer reporting agencies may not report outdated negative information. In most cases, a consumer reporting agency may not report negative information that is more than seven years old, or bankruptcies that are more than 10 years old.
• Access to your file is limited. A consumer reporting agency may provide information about you only to people with a valid need -- usually to consider an application with a creditor, insurer, employer, landlord, or other business. The FCRA specifies those with a valid need for access.
• You must give your consent for reports to be provided to employers. A consumer reporting agency may not give out information about you to your employer, or a potential employer, without your written consent given to the employer. Written consent generally is not required in the trucking industry. For more information, go to www.consumerfinance.gov/learnmore.
• You may limit "prescreened" offers of credit and insurance you get based on information in your credit report. Unsolicited "prescreened" offers for credit and insurance must include a toll-free phone number you can call if you choose to remove your name and address from the lists these offers are based on. You may opt out with the nationwide credit bureaus at 1-888-5-0PTOUT (1-888-567-8688).
• You may seek damages from violators. If a consumer reporting agency, or, in some cases, a user of consumer reports or a furnisher of information to a consumer reporting agency violates the FCRA, you may be able to sue in state or federal court.
• Identity theft victims and active duty military personnel have additional rights. For more information, visit www.consumerfinance.gov/learnmore.
States may enforce the FCRA, and many states have their own consumer reporting laws. In some cases, you may have more rights under state law. For more information, contact your state or local consumer protection agency or your state Attorney General.

SUMMARY OF RIGHTS UNDER CIVIL CODE SECTION 1786.22

(a) An investigative consumer reporting agency shall supply files and information required under Section 1786.10 during normal business hours and on reasonable notice.

(b) Files maintained on a consumer shall be made available for the consumer's visual inspection, as follows:

(1) In person, if he or she appears in person and furnishes proper identification. A copy of his or her file shall also be available to the consumer for a fee not to exceed the actual costs of duplication services provided.

(2) By certified mail, if he or she makes a written request, with proper identification, for copies to be sent to a specified addressee. Investigative consumer reporting agencies complying with requests for certified mailings under this section shall not be liable for disclosures to third parties caused by mishandling of mail after such mailings leave the investigative consumer reporting agencies.

(3) A summary of all information contained in files on a consumer and required to be provided by Section 1786.rn shall be provided by telephone, if the consumer has made a written request, with proper identification for telephone disclosure, and the toll charge, if any, for the telephone call is prepaid by or charged directly to the consumer. The term "proper identification" as used in subdivision shall mean that information generally deemed sufficient to identify a person. Such information includes documents such as a valid driver's license, social security account number, military identification card, and credit cards. Only if the consumer is unable to reasonably identify himself or herself with the information described above, may an investigative consumer reporting agency require additional information concerning the consumer's employment and personal or family history in order to verify his or her identity.

(c) The term "appropriate identification" used in a break means that the information is generally considered sufficient to identify the person. Such information includes documents such as a valid driving license, social security account number, military identification card and credit cards. Only if the consumer is not able to reasonably identify himself or himself with the information described above, the investigation agency may request additional information regarding the employment of the consumer and personal or family history in order to verify his or her identity.

(d) The investigative consumer reporting agency shall provide trained personnel to explain to the consumer any information furnished him or her pursuant to Section 1786.10.

(e) The investigative consumer reporting agency shall provide a written explanation of any coded information contained in files maintained on a consumer. This written explanation shall be distributed whenever a file is provided to a consumer for visual inspection as required under Section 1786.22.

(f) The consumer shall be permitted to be accompanied by one other person of his or her choosing, who shall furnish reasonable identification. An investigative consumer reporting agency may require the consumer to furnish a written statement granting permission to the consumer reporting agency to discuss the consumer's file in such person's presence.
Should be Empty:

Employment Application

BACKGROUND CHECK DISCLOSURE

BACKGROUND CHECK AUTHORIZATION

EEO-1 Voluntary Self Identification Form

STATE NOTICE PERTAINING TO BACKGROUND CHECKS

SUMMARY OF RIGHTS UNDER CIVIL CODE SECTION 1786.22