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Employment

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Employment Inquiry Form

Name:  *
Email:  *
Address:
City:
ZIP:
Phone:  *
Mobile:
Are you legally entitled to work in the U.S.?	Yes  No
If you are legally entitled to work in the United States we will require that you comply with Federal Regulations and provide appropriate identification/documentation.	Do you understand and agree? Select one YES NO .
What date are you available to start work?
Have you ever been convicted of a criminal offence including misdemeanors?	Yes  No
I will agree to a criminal background and/or state police check:	Yes  No
Are you 18 years of age or older?	Yes  No
Do you have reliable transportation?	Yes  No If yes please tell us how you will get to work:
Are you currently employed?	Yes  No
Current Employer:
Company:
Dates of employment:
Supervisor name:
Phone:
Previous Employment:
Company:
Dates of employment:
Supervisor name:
Phone:
Do you have commercial cleaning experience?	Yes  No
If yes, explain below
How many hours do you want per shift?	2 hours per day 3 hours per day 4 hours per day 5 hours per day
How many nights per week do you want to work?	2 days a week 3 days a week 4 days a week 5 days a week Weekends only
Please understand that because we provide janitorial services most of our work is performed on second or third shift. Are you able to work evenings Monday-Friday?	Yes  No
Can you work weekends?	Yes  No
I will agree to substance abuse testing and understand that COMPANY NAME reserves the right to perform random drug screenings at the companies expense:	Yes  No
How were you referred to us?	Select One One of your staff Internet search for employment Another Missouri Website CleanPeers.com Job Postings Other- specify below
Briefly tell us about yourself: