Employment Application

IMPORTANT

YOU MUST HAVE A RELIABLE VEHICLE AND A VALID DRIVERS LICENSE

YOU MUST HAVE A PHONE

YOU MUST BE ABLE TO WORK NIGHTS AND WEEKENDS

YOU MUST BE ABLE TO PASS A BACKGROUND TEST AND DRUG TEST

YOU MUST MEET ALL THE ABOVE QUALIFICATIONS FOR EMPLOYMENT

First and Last Name  

Street Address

City

State

Zip Code

Home Phone

Cell Phone

Email Address

Position You Are Applying For:

Did You Graduate High School?

Yes

No

Employment History

Note: You  Must List At Least Three Verifiable Former Employers To Be Considered For Employment

Employer Name

City

State

Worked From

mm/yy

Worked To

mm/yy

Position

Pay Rate

Reason For Leaving

Employer Name

City

State

Worked From

mm/yy

Worked To

mm/yy

Position

Pay Rate

Reason For Leaving

Employer Name

City

State

Worked From

mm/yy

Worked To

mm/yy

Position

Pay Rate

Reason For Leaving

Experience In Cleaning Or Floor Care

Please list all experience you have including where you worked & how long you did it

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 from 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 waiver does not permit the release or use of disability related or medical information in a manner prohibited by the Americans With Disabilities Act (ADA) and other relevant federal and state laws.

Date (mm/dd/yy)

Please type your name and your date of  birth to validate your signature