Employment Opportunities

Employment Application

All applicants are considered according to available contract work, on part-time bases for the length of the contract. Payments are based on each individual contract, not an across the board minimum/maximum pay scale. Completion of this form does not guarantee an employment offer for a contract, and is not based on his/her sex, race, age, religion, or marital status. It is necessary that we have a means for contacting you by phone, and that you have access to public or private transportation.

"*" indicates required fields

Position applying for*

Heavy Work Floor Care

Routine Cleaning

How did you hear about us?*

Name*

First Middle Last

Email*

Birthday m/d/y*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Home Phone

Cell Phone*

Soc Sec #

Do you have a full time job?*

Yes

If yes, please provide company name, address, contact to verify employment

Do you have previous janitorial experience?*

Yes

Please list your experience in each area, and overall, how long you were employed doing this type work:

What type of transportation do you have?*

My own vehicle

Public transportation

Please list the last two places you have worked in the last five years. What was your reason for leaving?

Company #1: Dates worked, reason for leaving*

Company #2: Dates worked, reason for leaving

What is your highest level of education*

Name of Institution

When did you graduate?

Address of school

Please answer the following questions with all honesty. Some clients may have need of this information; it will only be used in consideration of employment based on the individual contract requirements. All information will be kept confidential.

Have you ever been arrested?*

Yes

What was the reason for your arrest?

Have you ever been convicted of a felony?*

Yes

Are you willing to take a drug test?*

Yes

Do you have any illness that could interfere with your job performance, such as allergies (chemical, dust, etc.), problem lifting (back, abdomen, shoulders, etc.)

Yes

If Yes, please explain

Will you agree to a criminal background check?*

Yes

If employment offer is made, can you provide the necessary legal documents to support eligibility to work in the United States?*

Yes

I certify that answers given are true and complete to the best of my knowledge. I understand that any investigation of all statements contained in this application, criminal or otherwise, will be used for consideration of contract employment only, and is cause for dismissal if false or misleading information has been given. I also understand that if an offer of employment is made, I must sign a contract as evidence that I am in agreement with the terms of the contract.

If you affirm the above statement, type your name in the field*

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