Application For Employment

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Employment Application
First Nameyour full name
Middle Nameyour full name
Last Nameyour full name
Street Address
City State
Zip Code
How were you referred to us?pick one!
How long have you lived at your current address?
If less than 5 years what was your previous address?
How long at previous address?
Phone
Emergency Contact
Date You Can Start
Do you have a valid drivers license?pick one!
Are you comfortable climbing up and down ladders and also walking/working on roofs?pick one!
Are you over the age of 18?pick one!
Are you willing to work outdoors in the heat, cold, and other weather conditions?pick one!
Do you have a working smart phone and data plan that can be used at work?pick one!
Do you have your own reliable vehicle that is not shared with anyone else?pick one!
You certify that you are a U.S. citizen, permanent resident or foreign national authorized to work in the U.S.pick one!
Have you ever been convicted of or entered a plea of guilty, no contest or had a withheld judgement of a felony?pick one!
If Yes, please explain
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Are you able to make it to work Monday thru Friday starting at 7:30am?pick one!
Are you able to work Saturdays if needed?pick one!
Have you been cited for a DWI or DUI in the last 5 years?pick one!
Job Skills & Training
Name of High School
Start Date
End Date
Did you Graduatepick one!
List college
Start Date
Start Date
Did you Graduatepick one!
Are You Currently Employed?pick one!
Current or Previous Employer
Job Title
Reason for leaving
May we contact employer?pick one!
Supervisor name and phone number
Start Date
End Date
Previous Employer
Job Title
Reason for leaving
May we contact employer?pick one!
Supervisor name and phone number
End Date
Start Date
Describe your skills or training that may help with the position you are applying for:more details
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References - Please list three (3) references (not inluding immediate family or someone living with you)
Reference 1
Nameyour full name
Phone Number
Reference 2
Nameyour full name
Phone Number
Reference 3
Nameyour full name
Phone Number

I hereby certify that all responses set forth during my employment application process are true and complete. My signature also authorizes Superior Professional Window Cleaning LLC. or its authorized agents to conduct a thorough investigation of all statements, written and oral, made by me during the employment application process, including without limitation, information concerning my prior employment positions, driving record, law enforcement record, and educational background. I hereby authorize all persons, companies or other entities connected with any such informational request, including without limitation, physicians, hospitals, prior employers, and law enforcement agencies to provide any and all information and or medical records they may have regarding me or my employment. I release and agree to indemnify Superior Professional Window Cleaning LLC., its authorized agents, and its employees, and all other persons, companies, and other entities from any and all liability arising out of such investigation, including without limitation any liability for furnishing information or for taking any action based on the information provided.I understand and agree that any falsification, misrepresentation, or omission either on the employment application form or in my responses to questions asked during the interviewing or examination process may disqualify me from further consideration for employment, or if employed by Superior Professional Window Cleaning LLC., will subject me to immediate termination, whenever the falsification or omission is discovered. In this regard, where an item is left blank on the employment application, it is because there is no information within its scope.I understand that a physical examination and a chemical test for the presence of illegal and controlled substances, may be required before the commencement of and or during my employment. I release and agree to indemnify Superior Professional Window Cleaning LLC., its authorized agents, and its employees, and all other persons, companies, and other entities from any and all liability arising out of any physical examination or chemical testing or for the taking of any action based on the results of any physical examination or chemical testing.I understand and agree that if I am employed my employment is at-will so that I may terminate my employment at any time and for any or no reason. Likewise, Superior Professional Window Cleaning LLC., can terminate my employment at any time, with or without notice, and for any or no reason.

I have read and agree to the above applicant statement.pick one!
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