Last Name: |
|
First Name: |
|
Middle Initial: |
|
Email Address: |
|
Address: |
|
City: |
|
State: |
|
Zip code: |
|
Social Security Number: |
|
Phone: (Including area code) |
|
Age: |
|
Position applied for: |
|
Please check your work schedule preference: |
Full Time
Part Time
Either |
Have you ever worked for J4K Cleaning?
(If yes, describe and include dates) |
Yes
No
|
Have you ever been convicted of a Felony?
(If yes, describe and include dates) |
Yes
No
|
| Education Record |
High School |
|
School Name: |
|
School Address: |
|
Did you graduate? |
Yes
No |
| College |
|
School Name: |
|
School Address: |
|
Did you graduate? |
Yes
No |
Course of Study: |
|
Personal References
(Not related to you)
|
Name: |
|
Home Address: |
|
City, State, Zip: |
|
Phone: |
|
Job Title: |
|
Name of Business & Address: |
|
Name: |
|
Home Address: |
|
City, State, Zip: |
|
Phone: |
|
Job Title: |
|
Name of Business & Address: |
|
Employment Record
(Begin with your most recent employer) |
Company Name: |
|
Company Address: |
|
City, State, Zip: |
|
Phone: |
|
From - To: |
|
Supervisor: |
|
Describe your job duties: |
|
May we request a reference?
(If no, please explain why) |
Yes
No
|
Reason for leaving: |
|
Company Name: |
|
Company Address: |
|
City, State, Zip: |
|
Phone: |
|
From - To: |
|
Supervisor: |
|
Describe your job duties: |
|
May we request a reference?
(If no, please explain why) |
Yes
No
|
Reason for leaving: |
|
Company Name: |
|
Company Address: |
|
City, State, Zip: |
|
Phone: |
|
From - To: |
|
Supervisor: |
|
Describe your job duties: |
|
May we request a reference?
(If no, please explain why) |
Yes
No
|
Reason for leaving: |
|
Have you ever been discharged or requested to resign?
(If yes, please explain why) |
Yes
No
|
| I understand that J4K Cleaning Company may conduct investigations including a verification of employment history, volunteer work, education and references. By submitting this application, I authorize the company to make these investigations and I release and waiver my right to make any claims against third parties for anything they may say when complying or attempting to comply with such investigations. I am aware that false statements or failure to disclose information may disqualify me for employment, or if employed, may result in my dismissal. I also understand that employment (if offered) is for no definite period. If hired, I understand that I must provide required documents proving my identity and eligibility for employment. |
|