Power Clean U.S. - Online Job Application

Job Postings

Employment Application

Date of Application:
Position Applied For:
PERSONAL INFORMATION
First:
Last:
Init:
Social Security #:
Date Of Birth:
Sex:	Male Female
HOME ADDRESS
Street:
City:
State:
Zip:

CONTACT INFORMATION
Home Phone:
Work Phone:
Cell Phone:
Other Phone:
Email:
APPLICATION INFORMATION
Salary Requirments:
Are you 18 or older?	Yes No
Do you have a valid drivers License?	Yes No
If YES, Date of expiration:
Do you have reliable Transportation?	Yes No
Type Of Transportation?
Have you ever been employed by a Cleaning Service Company?	Yes No
If YES, when?
If YES, which state?
Interested In: (Check all that apply)
Full Time	Part Time	Temporary
Availability: (Check all that apply)
Any Time Any Shift	Weekdays Days	Weekends Evenings
If not available for any time/any shift, list days and times you are available:

When are you not available to work? List dates and times.

Do you plan to work another job?	Yes No
If yes, where and what hours?

List *ALL* violations of any type, you have received within the past 10 years. Including traffic violations:

Work History - Please list your previous employers with the most recent first:
Company Name:
Street:
City:
State:
Zip:
Supervisor:
Phone:
Employed From:	To:	(mm/yy)
*Responsibilities:*

*Reason for Leaving:*

Pay:
Employer 2
Company Name:
Street:
City:
State:
Zip:
Supervisor:
Phone:
Employed From:	To:	(mm/yy)
*Responsibilities:*

*Reason for Leaving:*

Pay:
Employer 3
Company Name:
Street:
City:
State:
Zip:
Supervisor:
Phone:
Employed From:	To:	(mm/yy)
*Responsibilities:*

*Reason for Leaving:*

Pay:
REFERENCES
List three people, not related to you, that you have known for at least one year: Please list name, phone number.

APPLICATION WAIVER
I, , have submitted an application with Power Clean Inc. I certify that all information supplied by me on this employment application is true and accurate and I authorize a complete investigation. I agree that, if hired, I may be discharged if Power Clean, Inc., at any time, learns of any falsification or material omission in the information I have provided and if discovered prior to hire, I would be ineligible for hire now and at anytime in the future. I authorize Power Clean, Inc. to contact all former and current employer references listed on my application. All references are authorized to release all information requested. I hereby release Power Clean, Inc. and all references from any liability which might be claimed because of information provided by such references. I understand nothing in Power Clean, Inc. employment application is intended to imply or create an employment relationship. I agree that, if hired, I will follow all company policies, rules, procedures, and all other directions. I further understand that, if hired, my employment is at-will, which means that I may terminate my employment at any time and for any reason, or no reason and that Power Clean, Inc. may conclude the employment relationship with me at any time and for any or no reason. Applicant full name: Date: (mm/dd/yyyy) Applications remain active for 60 days. If you wish to be considered for employment after 60 days from the date of this application, you will need to fill out a new application. Power Clean, Inc. Is An Equal Opportunity Employer