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                                ONLINE APPLICATION
  
NAME Last Name
 First Name
 Middle Inital
Present Address Street
 City
 State
 Zip
Permanent Address Street
 City
 State
 Zip
Contact Numbers Home#
 Work#
 Cell#
 
Emergency Contact Person
Name
Phone Number
 
Employment Desired
Position
 Date you can Start
 Salary Desired
DAYS YOU ARE AVAILABLE TO WORK.
(check all that apply)
 
TIMES YOU ARE AVAILABLE TO WORK.
(check all that apply)
Are you employeed now?
 If so may we inquire of your present employer?
Present Employer Name
 Contact Name
 Phone
Ever applied to this company before?
 If so, When?
Referred by:
Current Employee
Other
 
Education
Education Name & Location of School No Of
Years
Attended		 Did you graduate Subjects Studied
High School
College
Other
 
GENERAL
Cleaning Experience
Former Employers
(list below last three(3) employers, starting with the last one first)
Date
Month/Year		 Business Name Address Phone Contact Name Reason for
Leaving
FROM
TO
FROM
TO
FROM
TO
Which of these jobs did you like best?
What did you like most about this job?
REFERENCES
Give the names of three persons not related to you, whom you have known at least one year.
Name Address Phone Business Years Acquainted
 
I CERTIFY THAT ALL THE INFORMATION SUBMITTED BY ME ON THIS APPLICATION IS TRUE AND COMPLETE, AND I UNDERSTAND THAT IF ANY FALSE INFORMATION, OMISSIONS, OR MISREPRESENTATIONS ARE DISCOVERED, MY APPLICATION MAY BE REJECTED AND, IF I AM EMPLOYED, MY EMPLOYMENT MAY BE TERMINATED AT ANY TIME.

IN CONSIDERATION OF MY EMPLOYMENT, I AGREE TO CONFORM TO THE COMPANY'S RULES, POLICIES, AND REGULATIONS, AND I AGREE THAT MY EMPLOYMENT AND COMPENSATION CAN BE TERMINATED, WITH OR WITHOUT CAUSE, AND WITH OR WITHOUT NOTICE, AT ANY TIME, AT EITHER MY OR THE COMPANY'S OPTION. I ALSO UNDERSTAND AND AGREE THAT THE TERMS AND CONDITIONS OF MY EMPLOYMENT MAY BE CHANGED, WITH OR WITHOUT CAUSE, AND WITH OR WITHOUT NOTICE, AT ANY TIME BY THE COMPANY.

I UNDERSTAND THAT NO COMPANY REPRESENTATIVE, OTHER THAN IT'S PRESIDENT, AND THEN ONLY WHEN IN WRITING AND SIGNED BY THE PRESIDENT, HAS ANY AUTHORITY TO ENTER INTO ANYAGREEMENT FOR EMPLOYMENT FOR ANY SPECIFIC PERIOD OF TIME, OR TO MAKE ANY AGREEMENT CONTRARY TO THE FOREGOING.