Apply Now - Extreme Clean Mobile Washing, Inc.

Company

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Applicant Information

Name(Required)

First Name Middle Initial Last Name

Primary Phone Number(Required)

Secondary Phone Number

Email Address(Required)

Address

Street Address City State Zipcode

Are you 18 years or older?

Are you prevented from lawfully becoming employed in this country because of Visa or Immigration status?

Employment Desired

Desired Position

Date you can start

Wage Desired

Referred By

Have you ever applied to this company before?

When?

Have you been convicted of a felony or misdemeanor that has not been expunged by a court?

Explain

Education

Column Start

Highschool / GED

Name

Location

Did you graduate?

If No, # of years left to Graduate

Graduation Date

Degree Received

Column Start

University / College

Name

Location

Did you graduate?

If No, # of years left to Graduate

Graduation Date

Degree Received

Major

Column Start

Professional / Vocational

Name

Location

Did you graduate?

If No, # of years left to Graduate

Graduation Date

Degree Received

Major

Column End

Professional References

Please list three professional references.

Column Start

Full Name

Company

Relationship

Phone Number

Column Start

Full Name

Company

Relationship

Phone Number

Column Start

Full Name

Company

Relationship

Phone Number

Column End

Previous Employment

Column Start

Past Employer 1

Company

Phone

Address

Supervisor

Job Title

Starting Salary

Ending Salary

Responsibilities

From

Reason for leaving

May we contact your previous employer for a reference?

Column Start

Past Employer 2

Company

Phone

Address

Supervisor

Job Title

Starting Salary

Ending Salary

Responsibilities

From

Reason for leaving

May we contact your previous employer for a reference?

Column Start

Past Employer 3

Company

Phone

Address

Supervisor

Job Title

Starting Salary

Ending Salary

Responsibilities

From

Reason for leaving

May we contact your previous employer for a reference?

Column End

Military Service

Branch

Rank at Discharge

From

Type of Discharge

If other than honorable, explain

Can you provide a copy of your DD214?

Disclaimer

PLEASE READ CAREFULLY AND SIGN THAT YOU UNDERSTAND AND ACCEPT THIS INFORMATION.

Signature

I certify that the information on this application and its supporting documents is accurate and complete. I understand and agree that failure to fully complete the form, or misrepresentation or omission of facts, represents grounds for elimination from consideration for employment, or termination after employment if discovered at a later date. I authorize to investigate, without liability, all statements contained in this application and supporting materials. I authorize references and former employers, without liability, to make full response to any inquiries in connection with this application for employment. If requested, I agree to submit to a criminal background investigation, credit check, and screening for illegal substances upon conditional offer of employment. I understand that this document is NOT an offer of employment, and that an offer of employment, if tendered, does NOT constitute a contract for continued guaranteed employment. I understand that employees of serve at-will, and the employment relationship may be terminated at any time by either party, or any or no reason, other than a reason prohibited by law. If employed, I will be required to furnish proof of eligibility to work in the United States, and I will be required to comply with company policies and procedures.