Today’s date:
Position you are applying for (check that which applies): Cleaner Floor Tech Manager
Full Name:
Address: City: Zip Code:
Day Phone: - - Alternate Phone: - -
Are you at least 18 years of age? Yes No If No, do you have a work permit? Yes No
Do you have a valid Driver’s License? Yes No
Driver’s License Number: Issuing State: Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Expiration Date:
Do you have your own transportation to and from the job site? Yes No
Wage Desired:
Applying For: Full Time Part Time 1st Shift 2nd Shift 3rd Shift
Date you can start:
Number of hours you are looking per week:
Days and hours you are AVAILABLE to work. Please check all times and days you are available. Monday Tuesday Wednesday Thursday Friday Saturday Sunday
Are you currently employed? Yes No
If Yes… May we contact your current employer? Yes No
Do you plan on continuing employment if hired by A&L Janitorial? Yes No
Please list complete employment history for the last four years beginning with your most recent employer. Use a seperate piece of paper if necessary.
Describe your duties and responsibilities for this job:
Please list three individuals you have known for at least one year that would be able to give a personal reference on your behalf regarding your work ethic and personal character. Do not include family members or previous employers listed elsewhere on this application.
Military Service Record Branch of Services: Rank: Date of Service: Reserve Obligations: Date of Discharge: Type of Discharge:
Have you ever been convicted of a felony? If yes please explain below:
Please list any hobbies, interests, or special training you have that you feel helps make you an asset to our team.
“By signing below I certify that the information given in this application is true and complete to the best of my knowledge. I understand that if employed, falsified statements on this application for employment shall be ground for immediate dismissal. I authorize the investigation of all statements contained herein and the references and employers listed above to release A & L Janitorial, Inc. any and all information concerning my previous employment and/or any pertinent information they may have, personal or otherwise, to release A & L Janitorial, Inc. from any and all liability for any damage that may result from utilization of such information. I understand that A & L Janitorial, Inc. is an “at will” employer. No representative of A & L Janitorial, Inc. has any authority to go into any agreement for employment for any specified period of time, or to make any agreement contrary to the forgoing, unless in writing and signed by an authorized company representative. I give permission to A & L Janitorial, Inc. to perform criminal background check. I give permission to A & L Janitorial, Inc. to perform a drug screen by means they feel necessary and agree to submit to a specimen upon request, I understand and agree that I may be subject to random drug screening if employed.”
Signature of Applicant Date:
