First Name:*
Are you 18 or older?
Last Name:*
Nickname:
Phone:*
Cell Phone:
Street Address:*
Street Address 2:
city:*
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Work Authorization:*
Employment Status:
Work History (associate):
Ok to Contact
Starting Range of Pay:
Company Name:
Final Rate of Pay:
Company Street:
Direct Supervisor:
Company City & State:
Supervisor Title:
Company Phone:
Reason For Leaving:
Title:
Explanation:
Date From Month:
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Date To Month:
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School Name:
Did you graduate?
City:
Last year completed:
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Major/Degree:
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Referred by:
Primary Email:
Have you applied for a position with ALL-CleanUSA before?
Do you have reliable transportation to work?
Do you have a valid driver's license?
During the past 7 years, have you ever been convicted of a crime?
If you answered yes to the above question, please describe the circumstances of your conviction.
Please select the answer that best describes your high school education level.
Please select the answer that best describes your college education level.
Please indicate your availability to work. (hold "Ctrl" to select multiple responses)
How many hours are you available to work each week?
Are you involved in any extracurricular activities that affect your scheduling?
Please list activities and time commitment involved.
By checking the box, I acknowledge that the facts set forth on this application are true and complete. I understand that any false statements or omission on this application shall be sufficient cause for dismissal. I understand that all employees of ALL-CleanUSA are employees at will and that the employment relationship can be terminated at any time, with or without cause, at either the option of the employee or the option of ALL-CleanUSA. I specifically authorize ALL-CleanUSA, to obtain any and all employment records, reports, information, data or copies thereof, from any of my previous employers listed above; and I further authorize any previous employers to provide ALL-CleanUSA, such information that in any way relates to my employment history and performance. I understand that I will be required to provide a urine sample for drug testing as a requirement of employment, and I hereby consent to provide a urine specimen to ALL-CleanUSA, and consent to the testing of that specimen by a laboratory chosen by ALL-CleanUSA, and management and/or to any outside reviewing agent chosen by ALL-CleanUSA.
By checking the box, I understand that ALL-CleanUSA is an equal opportunity employer. In compliance with federal and state equal opportunity laws, qualified applicants are considered for all positions without regard to race, color, sex, sexual orientation, national origin, age, military status, or disability, as defined by federal and state law.
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