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Employment Application
Use the form below to inquire about employment opportunities with our company.
Personal
Full Name (First + Middle + Last)
*
Drivers License Number & State Issued
*
Street Address
*
Apartment, suite, etc
City
State/Province
ZIP / Postal Code
Phone
*
Email Address
*
Do you have the legal right to live and work in the U.S.?
*
Yes
No
Have you ever been convicted of a felony?
*
Yes
No
Will you comply with the safety work and attendance policies of our organization?
*
Yes
No
Employment Interests
Position(s) Desired or Area of Interest:
Janitorial
Floor Technician
Date Available
*
Type of Employment You Are Seeking:
*
Full-Time
Part-Time
Temporary
If temporary, until when are you available?
*
How will you get to work?
References
Reference 1
Name
Phone
Address
Occupation
Years Known
Add another reference
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Reference 2
Name
Phone
Address
Occupation
Years Known
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Reference 3
Name
Phone
Address
Occupation
Years Known
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Reference 4
Name
Phone
Address
Occupation
Years Known
Add another reference
Add another reference
Reference 5
Name
Phone
Address
Occupation
Years Known
Employment History
Company Name & Type of Business (Most Recent)
Street Address
Apartment, suite, etc
City
State/Province
ZIP / Postal Code
Country
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Australia
Aruba
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cabo Verde
Cayman Islands
Central African Republic
Chad
Chile
China, People's Republic of
Christmas Island
Cocos Islands
Colombia
Comoros
Congo, Democratic Republic of the
Congo, Republic of the
Cook Islands
Costa Rica
Côte d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
East Timor
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
France, Metropolitan
French Guiana
French Polynesia
French South Territories
Gabon
Gambia
Georgia
Germany
Guernsey
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island And Mcdonald Island
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Johnston Island
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kosovo
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
North Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montserrat
Montenegro
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Reunion Island
Romania
Russia
Rwanda
Saint Kitts and Nevis
Saint Lucia
Saint Vincent and the Grenadines
Samoa
Saint Helena
Saint Pierre & Miquelon
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and South Sandwich
Spain
Sri Lanka
Stateless Persons
Sudan
Sudan, South
Suriname
Svalbard and Jan Mayen
Swaziland
Sweden
Switzerland
Syria
Taiwan, Republic of China
Tajikistan
Tanzania
Thailand
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks And Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
US Minor Outlying Islands
United States of America (USA)
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
Virgin Islands, British
Virgin Islands, U.S.
Wallis And Futuna Islands
Western Sahara
Yemen
Zambia
Zimbabwe
Dates Employed
From
To
Add Dates
Add Date
From
To
Add Dates
Add Date
From
To
Add Dates
Add Date
From
To
Supervisor's Name
Supervisor's Phone
Base Rate of Pay (Hour/Week/Month)
Starting Pay
Ending Pay
Description of Duties
Reason for Leaving
Have you ever had a job doing janitorial work?
*
Yes
No
I agree to a Drug Screening at the company's expense.
*
Yes
No
I agree to a Criminal Background Check at the company's expense.
*
Yes
No
Acknowledgement
Insert Your Legal Terms of Service Here
Digital Signature
*
Printing your First Name + Middle Initial + Last Name will act as your digital signature.
Date
Resume Upload (Optional)
Choose File
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Accepted file types: doc, docx, pages, odt, rtf, tex, txt, wpd, wps, pdf, Max. file size: 100 MB.
Would you like to add a cover letter?
Yes
No
Cover Letter (Optional)
Choose File
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Accepted file types: doc, docx, pages, odt, rtf, tex, txt, wpd, wps, pdf, Max. file size: 100 MB.
Please upload your cover letter or copy and paste the contents of your cover letter in the space below.
Submit Application