CLEANING AND SUCH Ltd. NOTE: Completed applications can be sent via: 503 N. Main St. M ail: Address on top of Gibsonburg, Ohio 43431-1113 application (419) 637-7644 Fax: 419-637-9935 Email: (Please Print) APPLICATION FOR EMPLOYMENT [email protected]. (THIS APPLICATION IS OPEN FOR 30 DAYS ONLY!) Applications dropped off at Cleaning and SuchLtd. will not DATE ______SOCIAL SECURITY NAME ______NUMBER ______LAST FIRST MIDDLE ADDRESS ______STREET CITY STATE ZIP PHONE NO. ______EMAIL ______ARE YOU 18 YEARS OR OLDER? YES____ NO ___ ARE YOU LEGALLY ELIGIBLE FOR EMPLOYMENT IN THE UNITED STATES? YES_____ NO____ HAVE YOU BEEN CONVICTED OR PLEAD NO CONTEST TO A CRIME? YES_____ NO ____ VALID DRIVERS LICENSE? YES ______NO ______VALID AUTO INSURANCE? YES_____ NO____ EMPLOYMENT DESIRED POSITION ______DATE YOU CAN START ______WAGE DESIRED ______ARE YOU EMPLOYED NOW? _____ MAY WE INQUIRE OF YOUR PRESENT EMPLOYER? ______EVER APPLIED TO THIS COMPANY BEFORE? ______WHEN? ______HOW DID YOU HEAR ABOUT THIS JOB? ______(A current employee, school, newspaper, etc..) EDUCATION NAME & LOCATION *NO. OF YEARS DID YOU SUBJECTS OF SCHOOL ATTENDED GRADUATE? STUDIED
HIGH SCHOOL
COLLEGE
TRADE, BUSINESS, CORRESPONDENCE SCHOOL
REFERENCES: THREE PERSONS NOT RELATED TO YOU, WHOM YOU HAVE KNOWN AT LEAST ONE YEAR.) MUST have complete names, addresses & phone numbers) NAME ADDRESS PHONE YEARS AQUAINTED 1
2
3
GENERAL WHEN IS THE BEST TIME TO CALL YOU DURING THE DAY? ______PLEASE SPECIFY THE HOURS ARE YOU LOOKING TO WORK: ______(CONTINUED ON OTHER SIDE) FORMER EMPLOYERS (LIST BELOW YOUR LAST THREE EMPLOYER, STARTING WITH LAST OR PRESENT ONE FIRST) You MUST include a phone number with area code and a COMPLETE address EMPLOYER YOUR JOB TITLE YOUR SUPERVISOR’S NAME/TITLE
ADDRESS CITY STATE/ZIP TELEPHONE NUMBER
DATES:
FROM: TO: SALARY/WAGES START: FINISH: REASON FOR LEAVING: __RESIGNED WITH NOTICE __QUIT (NO NOTICE) __TERMINATED IF TERMINATED, PLEASE STATE REASON:
MAY WE CONTACT THIS EMPLOYER? __YES __NO
EMPLOYER YOUR JOB TITLE YOUR SUPERVISOR’S NAME/TITLE
ADDRESS CITY STATE/ZIP TELEPHONE NUMBER
DATES:
FROM: TO: SALARY/WAGES START: FINISH: REASON FOR LEAVING: __RESIGNED WITH NOTICE __QUIT (NO NOTICE) __TERMINATED IF TERMINATED, PLEASE STATE REASON:
MAY WE CONTACT THIS EMPLOYER? __YES __NO
EMPLOYER YOUR JOB TITLE YOUR SUPERVISOR’S NAME/TITLE
ADDRESS CITY STATE/ZIP TELEPHONE NUMBER
DATES:
FROM: TO: SALARY/WAGES START: FINISH: REASON FOR LEAVING: __RESIGNED WITH NOTICE __QUIT (NO NOTICE) __TERMINATED IF TERMINATED, PLEASE STATE REASON:
MAY WE CONTACT THIS EMPLOYER? __YES __NO
I certify that all the information supplied by me on my application for employment is true and complete. I understand that false or incomplete statements herein, or in any interview, resume or other document supplied, are grounds for rejection of my application or dismissal anytime after hiring. I understand that this application and if hired, any handbook, policy or other document/statement does not constitute a contract of employment and that I may voluntarily leave employment at any time and may be terminated from eployment at any time for any reason. I authorize investigation of all statements contained herein and the references listed above to give you any and all information concerning my previous employment and any pertinent information they may have, and release all parties from all liability for any damage that may result from furnishing same to you. DATE SIGNATURE
Please note: If you are working or going to school during the day, please leave a daytime work number or have an answering machine so that we may contact you. * The Age Discrimination Act of 1987 prohibits discrimination on the basis of age with respect to individuals who are at least 40 years of age.