Application

APPLICATION FOR EMPLOYMENT
APPLICANTS MAY BE TESTED FOR ILLEGAL DRUGS
Date Submitted:
 
 
Email:* Required
 
 
Name:* Required

                       (Last)
 

                       (First)
 

                       (Middle)
Present Address:* Required

                                                                           (Number, Street, City, State, Zip)
 
How long?:
Telephone
 
 
If under 18, please list age:
 
Position Applied For:* Required
Date Available:* Required
How many hours can you work weekly?:* Required
Can you work nights?:* Required
Days/hours available to work:
No Pref:

Mon:

Tue:

Wed:
 
 
Thurs:

Fri:

Sat:

Sun:
     
 
HAVE YOU EVER BEEN CONVICTED OF A CRIME?* Required No Yes
   
If yes, explain number of conviction(s), nature of offense(s) leading to conviction(s), how recently such offense(s) was/were committed, sentence(s) imposed, and type(s) of rehabilitation.
   
Do you give consent for Peeples Professional Cleaning Service to conduct a criminal background check?
* Required
Yes No
 
DO YOU HAVE A DRIVER'S LICENSE? Yes No
* Required
 
What is your means of transportation to work?:* Required
 
Have you had any accidents during the past three years? Yes No
* Required
How many?:
Have you had any moving violations during the past three years? Yes No
* Required
How many?:
 
 
EMPLOYMENT HISTORY
 
 
List complete employment history, including self-employment and periods of unemployment, from most recent to least.
EMPLOYMENT 1
Employer:
Date Employed From (Mo./Yr.):
Starting Position:
 
Date Employed To (Mo./Yr.):
Last Position:
Other Position:
Address:
Telephone:
 
Salary/Wage:
Starting:
 
Final:
 
Last Supervisor:
Duties in Position:
 
Reason for Leaving:
 
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EMPLOYMENT 2
Employer:
Date Employed From (Mo./Yr.):
Starting Position:
 
Date Employed To (Mo./Yr.):
Last Position:
Other Position:
Address:
Telephone:
 
Salary/Wage:
Starting:
 
Final:
 
Last Supervisor:
Duties in Position:
 
Reason for Leaving:
 
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EMPLOYMENT 3
Employer:
Date Employed From (Mo./Yr.):
Starting Position:
 
Date Employed To (Mo./Yr.):
Last Position:
Other Position:
Address:
Telephone:
 
Salary/Wage:
Starting:
 
Final:
 
Last Supervisor:
Duties in Position:
 
Reason for Leaving:
 
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EMPLOYMENT 4
Employer:
Date Employed From (Mo./Yr.):
Starting Position:
 
Date Employed To (Mo./Yr.):
Last Position:
Other Position:
Address:
Telephone:
 
Salary/Wage:
Starting:
 
Final:
 
Last Supervisor:
Duties in Position:
 
Reason for Leaving:
 
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EMPLOYMENT 5
Employer:
Date Employed From (Mo./Yr.):
Starting Position:
 
Date Employed To (Mo./Yr.):
Last Position:
Other Position:
Address:
Telephone:
 
Salary/Wage:
Starting:
 
Final:
 
Last Supervisor:
Duties in Position:
 
Reason for Leaving:
 
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EMPLOYMENT 6
Employer:
Date Employed From (Mo./Yr.):
Starting Position:
 
Date Employed To (Mo./Yr.):
Last Position:
Other Position:
Address:
Telephone:
 
Salary/Wage:
Starting:
 
Final:
 
Last Supervisor:
Duties in Position:
 
Reason for Leaving:
 
 
 
Enter Security Code: