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Cleaning
Green Maids APPLICATION
FOR EMPLOYMENT |
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Cleaning Green Maids, LLC. IS AN EQUAL OPPORTUNITY
EMPLOYER AND DOES NOT DISCRIMINATE IN HIRING OR EMPLOYMENT ON THE BASIS OF
RACE, RELIGION, COLOR, NATIONAL ORIGIN, SEX, AGE, DISABILITY, VETERAN STATUS
OR ANY OTHER PROHIBITED BASIS. NO
QUESTION ON THIS APPLICATION IS INTENDED TO SECURE INFORMATION TO BE USED FOR
SUCH DISCRIMINATION. |
Position Applying For: Date _______________
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Full Name: |
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Address: |
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City, State, Zip: |
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Home Phone |
Cell Phone |
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Email: |
Date of Birth |
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SS Number |
State of Birth |
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City of Birth |
Maiden Name |
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County of Birth |
Name:: Also known as |
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Note: Not required unless hired.
This information is used to run a
background check and is kept strictly confidential |
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In case of emergency,
please contact: |
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Do you have the legal
right to live and work in the U.S.? |
Yes |
No |
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If hired, can you provide the
documentation required by U.S. law? |
Yes |
No |
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Do you have a legal and current
Illinois State driver’s license? |
Yes |
No |
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Do you have an automobile? |
Yes |
No |
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If you answered ‘No’ to any of
the above questions, please explain here: |
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HAVE YOU: Since the age of 18, ever been convicted of a
misdemeanor or felony? If so, please
provide information on the nature and date.
NOTE: Background checks are run on all employees prior to
employment. A conviction will not
necessarily bar you from employment. Each conviction will be judged on its
own merits with respect to circumstances and seriousness |
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SKILLS AND QUALIFICATIONS |
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Summarize special skills and
qualifications acquired from employment or other experience relevant to this
position |
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Are you currently employed? |
If so, may we contact your present employer? |
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If you are accepted for employment, when would you be
available to start? |
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Hours are part-time and are scheduled between
the hours of 9 AM to 5 PM, based on the actual clients scheduled. |
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Are you able to work during our scheduled hours of
operation? If not, what are the time/day conflicts? |
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Are you able to work additional hours if needed? If so, which days and time frame(s) would
you be willing to work? |
EXPERIENCE: (Enter present / last
job first)- Please attach resume if
available
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NAME, ADDRESS AND PHONE # OF COMPANY |
DATE |
POSITION & DUTIES |
PAY RATE |
REASON FOR LEAVING |
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TO |
FROM |
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Supervisor: |
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2. |
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Supervisor: |
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3. |
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Supervisor: |
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REFERENCES:
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EDUCATION:
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NAME AND ADDRESS OF SCHOOL |
COURSES STUDIED |
LAST YEAR COMPLETED |
MONTH AND YEAR GRADUATED |
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HIGH
SCHOOL |
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9 10
11 12 |
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COLLEGE OR TECHNICAL |
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1 2
3 4 |
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OTHER |
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APPLICANT
CERTIFICATION
1.
I certify that the answers and information given in this
application are true and complete. I
understand that any false or misleading information provided, or omitted, on
this application, in my resume, or during any interview is grounds to
disqualify me for consideration for employment and, if discovered after my
hire, is grounds for discharge.
2.
Except where indicated above, I authorize you to contact
my present and former employers, references, schools, and other sources to
investigate my background and to verify any of the information contained in
this application, in any accompanying resume, or in any interview. I further authorize those employers,
references, schools, and other sources to give Cleaning Green Maids, LLC. any
and all information concerning my previous employment, education, conduct, and
any other relevant information they may have, personal or otherwise.
3.
I hereby release and forever discharge all such persons,
companies or other sources, and their agents and employees, and Cleaning Green
Maids, LLC. and its agents and employees, from any and all claims, known or
unknown, which may result from the disclosure or collection of the requested
information.
4.
I understand that this application for employment is not
a contract of employment and that if I am hired, my employment with Cleaning
Green Maids, LLC. is at‑will and can be terminated without cause and
without notice at the option of the company or myself.
5.
I certify that no representations have been made to me,
written or oral, that alter the at‑will nature of the employment
relationship. I further understand that
the at‑will nature of the employment relationship may not be changed
unless specifically acknowledged in writing by the President of Cleaning Green
Maids, LLC. in a document signed by both me and the President.
6.
By signing this document below, I hereby give my
permission for Cleaning Green Maids, LLC. to obtain information relating to my
criminal history record. The criminal history record, as received from the
reporting agencies, may include arrest and conviction data as well as plea
bargains and deferred adjudications. I understand that this information will be
used, in part, to determine my eligibility for an employment position with this
organization. I also understand that, as long as I remain an employee with
Cleaning Green Maids, LLC. the criminal history records check may be repeated
at any time. I understand that I will have an opportunity to review the
criminal history and a procedure is available for clarification if I dispute
the record as received.
I acknowledge by my signature that I
have read and understand the above.
DATE:
_________________ SIGNATURE:
_____________________________________________________
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This area is reserved for comments you
wish to make that is not covered in the application. Completion of this area is optional |
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