EMPLOYMENT APPLICATION Please Print and Completely ......Application will remain active for 30 days...
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Application will remain active for 30 days from above date 1 EMPLOYMENT APPLICATION Please Print and Completely Answer All Questions. POSITION APPLIED FOR: _______________________________ DATE: ______________________________ APPLICANT DATA Last Name First Middle Street Address City State/Zip Code Home Telephone Number Alternative Phone Number __________________________________________________________________________________________ Email Address When will you be available to start work? ________________________________________________________ Are you at least 18 years old? Yes No Please indicate days you’re available to work. Mon. Tues. Wed. Thurs. Fri. Sat. Please indicate what shift you’re available to work. 1 st 2nd 3rd Office Hours Only Are you available to work out of town, if required? Yes No Are you available to work overtime, if required? Yes No Are you legally authorized to work in the United States? Yes No How did you hear about us? Current/Former Employee Who should we thank? _______________________ Newspaper Friend Recruiting Firm Walk-in Other _______________________ Complete this section only if driving is indicated as a requirement for the position which you are applying. Otherwise, skip this section and go to Education. Do you have a valid Driver’s license? No Yes State & License No. ___________________________ Have you had any tickets? No Yes Explain_____________________________________________ __________________________________________________________________________________ Has your license been suspended or revoked? No Yes Explain_____________________________ ___________________________________________________________________________________ Do you have any DUI or DWI convictions? No Yes Explain (Include date) _____________________ _________________ _________________________________________________________________ Clean the World and all affiliates is an equal opportunity employer and does not discriminate against otherwise qualified applicants on the basis of race, color, religion, national origin, age, sex, veteran status, disability, or any other basis prohibited by federal, state, or local law. In accordance with Americans with Disabilities Act, it is our policy to provide reasonable accommodation upon request during the application process to eligible applicants in order that they may be given a full and fair opportunity to be considered for employment. Clean the World is a drug free workplace and participates in E-Verify.
Transcript of EMPLOYMENT APPLICATION Please Print and Completely ......Application will remain active for 30 days...
Applicationwillremainactivefor30daysfromabovedate 1
EMPLOYMENTAPPLICATIONPleasePrintandCompletelyAnswerAllQuestions.
POSITIONAPPLIEDFOR:_______________________________ DATE:______________________________APPLICANTDATALastName First MiddleStreetAddress City State/ZipCodeHomeTelephoneNumber AlternativePhoneNumber__________________________________________________________________________________________EmailAddressWhenwillyoubeavailabletostartwork?________________________________________________________Areyouatleast18yearsold?Yes�No�Pleaseindicatedaysyou’reavailabletowork.Mon.�Tues.�Wed.�Thurs.�Fri.�Sat.�Pleaseindicatewhatshiftyou’reavailabletowork.1st�2nd�3rd�OfficeHoursOnly�Areyouavailabletoworkoutoftown,ifrequired?Yes�No�Areyouavailabletoworkovertime,ifrequired?Yes�No�AreyoulegallyauthorizedtoworkintheUnitedStates?Yes�No�Howdidyouhearaboutus?Current/FormerEmployee�Whoshouldwethank?_______________________Newspaper� Friend� RecruitingFirm� Walk-in� Other�_______________________
Completethissectiononlyifdrivingisindicatedasarequirementforthepositionwhichyouareapplying.Otherwise,skipthissectionandgotoEducation.DoyouhaveavalidDriver’slicense?No�Yes�State&LicenseNo.___________________________Haveyouhadanytickets?No�Yes�Explain_______________________________________________________________________________________________________________________________Hasyourlicensebeensuspendedorrevoked?No�Yes�Explain________________________________________________________________________________________________________________DoyouhaveanyDUIorDWIconvictions?No�Yes�Explain(Includedate)_______________________________________________________________________________________________________
CleantheWorldandallaffiliatesisanequalopportunityemployeranddoesnotdiscriminateagainstotherwisequalifiedapplicantsonthebasisofrace,color,religion,nationalorigin,age,sex,veteranstatus,disability,oranyotherbasisprohibitedbyfederal,state,orlocallaw.InaccordancewithAmericanswithDisabilitiesAct,itisourpolicytoprovidereasonableaccommodationuponrequestduringtheapplicationprocesstoeligibleapplicantsinorderthattheymaybegivenafullandfairopportunitytobeconsideredforemployment.CleantheWorldisadrugfreeworkplaceandparticipatesinE-Verify.
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EMPLOYMENTAPPLICATION(CONTINUED)
EMPLOYMENTHISTORY(Coverthelastfiveyears.Startwithmostrecentemployer.Useadditionalpaperasneeded.Ifresumeprovidesemploymenthistoryandisattachedtoapplication,checkthisbox�andproceedtonextsection.)
DONOTLEAVEBLANKSPACES
CompanyName DatesEmployedFrom: To:Address RateofPayatTimeofSeparation
Seeattachedresumeforjobtitleanddutyinformation.�
CompanyName DatesEmployedFrom: To:Address RateofPayatTimeofSeparation______________ NameofSupervisor Tel#:()Maywecontact?Yes�No� ReasonforLeaving:StateJobTitlesandDescribeJobDuties:
CompanyName DatesEmployedFrom: To:Address RateofPayatTimeofSeparation______________ NameofSupervisor Tel#:()Maywecontact?Yes�No� ReasonforLeaving:StateJobTitlesandDescribeJobDuties:
CompanyName DatesEmployedFrom: To:Address RateofPayatTimeofSeparation______________ NameofSupervisor Tel#:()Maywecontact?Yes�No� ReasonforLeaving:StateJobTitlesandDescribeJobDuties:
CompanyName DatesEmployedFrom: To:Address RateofPayatTimeofSeparation______________ NameofSupervisor Tel#:()Maywecontact?Yes�No� ReasonforLeaving:StateJobTitlesandDescribeJobDuties:
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EMPLOYMENTAPPLICATION(CONTINUED)
EDUCATIONDoyouhaveahighschooldiplomaorGEDequivalent?Yes�No�Ifthepositionyouareapplyingforrequiresspecificeducationortraining,completethissection.Ifnoadditionalseculareducationand/ortrainingisrequiredforthisposition,youcanskipthissection.School________________________ Degree___________________________Graduated?Yes�No�School________________________ Degree___________________________Graduated?Yes�No�School________________________ Degree___________________________Graduated?Yes�No�School________________________ Degree___________________________Graduated?Yes�No�Training_______________________________________________________________________Certificates/Licenses____________________________________________________________EDUCATIONALANDPROFESSIONALAFFILIATIONSconsideredrelevanttojob(Youneednotdisclosemembershipinprofessionalorganizationsthatmayrevealinformationregardingrace,color,creed,sex,religion,nationalorigin,age,disability,maritalstatus,oranyotherprotectedstatus.)____________________________________________________________________________________________________________________________________________________________________________________GENERALINFORMATIONAnswerallquestions.Donotleaveanyblanks.Haveyoueverbeendischargedorforcedtoresignbecauseofconductorapolicy/proceduralviolation?No�Yes�Explain__________________________________________________________________________________________________________________________________________________________________Haveyourecentlybeenlaidoffandareeligibleforrecallbyaformeremployer?No� Yes�Haveyoureceivedanydisciplinarycounselinginthelasttwelvemonthsofemployment?No�Yes�Explain____________________________________________________________________________________________________________________________________________________________________________________Haveyousignedanyemploymentagreementand/ornon-compete/non-solicitagreementwithanyotheremployerthatmightrestrictyoufromworkingforthiscompany?No�Yes�Explain____________________________________________________________________________________________________________________________________________________________________________________________________
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ACKNOWLEDGEMENTANDAGREEMENTIcertifythattheanswersgivenhereinaretrueandcompletetothebestofmyknowledge.Iunderstandthatanymisrepresentations,omissionsorfactsorincompleteanswersinanyapplicationdocumentwilldisqualifymefromfurtherconsiderationofemployment.Ifurtherunderstandthat,ifemployed,anymisrepresentationsoromissionsoffactsinanyapplicationand/oremploymentdocumentswillbecauseformydismissalatanytimewithoutpriornotice.Iunderstandthat,ifemployedmyemploymentwithCleantheWorld(CTW)orCompanyisnotforaspecifictermandmaybeterminatedbymeorCTWwithorwithoutnoticeorcauseatanytime.Ifurtherunderstandthatnooralpromise,CTWpolicy,custom,businesspracticeorotherprocedure(includingtheEmployeeHandbookoranyotherpersonalmanual)constitutesanemploymentcontractormodificationoftheat-willemploymentrelationshipbetweenmeandCTW.Iunderstandthatapplicationsforcertainpositionsmayberequiredtoqualifyforemploymentbasedonadditionalemploymentcriteria.Forexample,Imayberequiredtotakejobrelatedtests;takeadriver’sexamination;submittoabackgroundinvestigation;takeapre-employmentdrugtest.IfIamofferedemploymenttostartworkbeforeanyrequiredtestiscompleted,myemploymentiscontingentonasatisfactoryresultonallrequiredtests.IauthorizetheCompanytocontactmyprioremployers,andothersourcesofinformationregardingmybackground,andIherebyauthorizeanddirecteachsuchemployerandsourceofinformationtoansweranyandallquestionsregardingmyprioremploymentandbackground.IherebyindemnifytheCompany,eachofmyprioremployers,andeachoftheothersourcesofinformationcontactedandagreetoholdharmlessfromanyclaimsarisingfromthisauthorizationanddirection.Iunderstandthatthisapplicationwillbeconsideredactivefor30-calendardaysfromthisdate.IfIhavenotheardfromthecompanyattheconclusionofthe30-calendardayperiod,itismyresponsibilitytocompleteanewapplicationifIwishtobeconsideredforemployment.APPLICANTSIGNATURE_______________________________ DATE________________________
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