Clean Care, Inc.

Online Employment Application Form

Clean Care, Inc. considers applicants for all positions without regard to race, color, religion, creed, gender, national origin, age, disability, marital or veteran status, or any other legally protected status.

Position(s) Applied For
Full or Part Time
Salary Desired
*Full Name
*Address
*Telephone Number
Alternate Telephone
E-mail

WORK EXPERIENCE - Start with your present or most recent employer

Employer Information 1

Name
Address
Job Title
Reason for Leaving
Dates Employed From
To
Rate of Pay Starting
Final
Work Performed
Supervisor
Telephone Number

Employer Information 2

Name
Address
Job Title
Reason for Leaving
Dates Employed From
To
Rate of Pay Starting
Final
Work Performed
Supervisor
Telephone Number

MILITARY

Did you serve in the U.S. Armed Forces?
Branch
Describe any training received relevant to the position for which you are applying.

PERSONAL

Do you have a telephone?
Do you own a reliable vehicle?
Have you ever been convicted of a crime?
If yes, describe in full.

APPLICANT’S STATEMENT

*I certify that answers given herein are true and complete.

I authorize investigation of all statements contained in the application for employment as may be necessary in arriving at an employment decision.

In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the employer.