EMPLOYMENT APPLICATION
Clean All Services is an equal opportunity employer and affords equal opportunity to all applicants for all positions without regard to race, color, religion, gender, national origin, age, marital status, sexual orientation, disability, veteran status or any other status protected under local, state or federal laws.

I understand that this application is considered current for three months. If I wish to be considered for employment after this period I must fill out and submit a new application.

Position applied for:
 		Date of application:
Last Name:
 First Name:
 		Middle Name:
Street Address:                                 City:                   State:             Zip Code:
              
Telephone Number:
 		Alternate Number:
 		Social Security #:
 
Are you legally eligible to work in the United States? (Proof of eligibility will be required upon offer of employment)

Yes No

 
Are you under the age of 18 years?

Yes No

 
Have you ever worked for Clean All Services before?

Yes No

If yes, please give date:

 
A requirement of this job is lifting 40 pounds without difficulty. Can you perform this duty with or without accommodation?

Yes No

 
Have you ever been convicted of a felony? (A conviction will not necessarily disqualify you.)

Yes No

If yes, please explain:

    
 
Is anyone related to you employed by Clean All Services?

Yes No

If yes, please give their name and relationship to you:

    
 

I want to apply for positions that require a valid driver's license and can provide a valid driver's license upon hire.

I want to apply for on the positions that do not require a valid driver's license.

For driving positions only. Have you been convicted of any moving violations in the past 5 years? (A conviction will not necessarily disqualify you.)

Yes No

If yes, please explain and provide approximate dates:

    

 
On what date are you available to start work? Date:
 

Days and hours available to work:

    

 

EDUCATION. Please indicate education or training which you believe qualifies you for the position you are seeking.
  Name and location of school Course of Study Years Completed DiplomaOrDegree
Elementary
High School
GED
Vocational
College

 

Describe and specialized training, apprenticeships, licenses or skills:

 

Have you received any job-related training in the United States Military?

Yes No

If yes, please give description:

 

EMPLOYMENT HISTORY. (Begin with current or most recent employer. Previous salaries or wages will not be used to determine compensation at Clean All Services. If employment was under a different name, indicate the name.)
May we contact your present employer for reference?     Yes No
Company Name:
 Address:
 Phone Number:
Employment Dates (month/year)

  From:             To:
      		Salary

  Start:            End:
      		Name of Supervisor:
Describe Your Duties:

    
Reason for Leaving:

    
 
Company Name:
 Address:
 Phone Number:
Employment Dates (month/year)

  From:             To:
      		Salary

  Start:            End:
      		Name of Supervisor:
Describe Your Duties:

    
Reason for Leaving:

    
 
Company Name:
 Address:
 Phone Number:
Employment Dates (month/year)

  From:             To:
      		Salary

  Start:            End:
      		Name of Supervisor:
Describe Your Duties:

    
Reason for Leaving:

    

 

APPLICANT ACKNOWLEDGEMENT AND AUTHORIZATION


*PLEASE READ CAREFULLY BEFORE SIGNING*


I hereby certify that all of the information provided by me in this application (or any other accompanying or required documents) is correct, accurate and complete to the best of my knowledge. I understand that the falsification, misrepresentation or omission of any facts in said documents will be cause for denial of employment or immediate termination of employment regardless of the timing or circumstances of discovery.

I understand that submission of an application does not guarantee employment. I further understand that, should an offer of employment be extended by CLEAN ALL SERVICES Corporation (hereinafter referred to as "CLEAN ALL SERVICES") that such employment with CLEAN ALL SERVICES is at will, for no specified duration and may be terminated by either CLEAN ALL SERVICES or myself at any time, with or without cause or notice. I understand that none of the documents, policies, procedures, actions, statements of CLEAN ALL SERVICES or its representatives used during the employment process is deemed a contract of employment real or implied. I understand that no representative of CLEAN ALL SERVICES except the President has the authority to enter into any agreement guaranteeing any conditions of employment or any agreement contrary to the foregoing statements and that any such agreements must be made in writing and signed by the President of CLEAN ALL SERVICES.

In consideration for employment with CLEAN ALL SERVICES, if employed, I agree to conform to the rules, regulations, policies and procedures of CLEAN ALL SERVICES at all times and understand that such obedience is a condition of employment. I understand that due to the nature of CLEAN ALL SERVICES business, attendance and punctuality are considered essential requirements of every job at CLEAN ALL SERVICES and that poor attendance or tardiness will result in disciplinary action.

I understand that if offered a position with CLEAN ALL SERVICES, I may be required to submit to a pre-employment medical examination, drug screening and background check as a condition of employment. I understand that unsatisfactory results from, refusal to cooperate with, or any attempt to affect the results of these pre-employments tests and checks will result in withdrawal of any employment offer or termination of employment if already employed.

I herby authorize any and all schools, former employers, references, courts and any others who have information about me to provide such information to CLEAN ALL SERVICES and/or any of its representatives, agents or vendors and I release all parties involved from any and all liability for any and all damage that may result from providing such information. As part of its employment process, Clean All Services may do a background check for employment purposes. Inquiry may include, but is not limited to, conviction records, motor vehicle records, references, drug test results, medical information, and copies of prior personnel files.

I understand that this application is considered current for three months. If I wish to be considered for employment after this period I must fill out and submit a new application.

BY SIGNING BELOW I ACKNOWLEDGE THAT I HAVE READ, UNDERSTOOD AND AGREE TO THE ABOVE STATEMENTS.
Signature:
 Date:
Name of person completing this form if other than applicant:
 Date: