Environment Control

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Personal Information

First Name *

Middle Name

Last Name *

Your e-mail address *

Best Contact Telephone No. *

()

Alternate Telephone No. *

()

Present Address *

City *

State/Province *

Zip/Postal code *

Can you provide proof that you can be lawfully employed in the U.S.? *

Yes No

Proof of citizenship or immigration status will be required upon employment.

We may check criminal records of applicants. Does your record include any convictions, guilty pleas, jail or prison time? *

Yes No

How were you referred to Environment Control? *

Education

Did You Graduate Highschool? *

Yes No N/A

Did You Graduate College, Trade or Business? *

Yes No N/A

Other janitorial experience *

Military Service - Dates of service, training, honors: *

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Former Employers

List below your last three employers, starting with the most current:

Current Employer

From *	Month and Year
To *	Month and Year
Name and Location of Company: *
Supervisor's Name - Telephone Number: *
Position *
Wage/Salary *
Reason for Leaving: *

Add Second Employer

Add Third Employer

References

List the names of two people not related to you who you have known for at least one year:

First Reference:
Name *
Telephone No. *	Please include their area code
Years Acquainted *
Second Reference:
Name *
Telephone No. *	Please include their area code
Years Acquainted *
In Case of Emergency Notify:
Name *
Telephone No. *	Please include their area code
Relationship *

Applications that are not complete and/or questions not fully answered will not be considered for employment.

I hereby affirm that the information provided on this application, and accompanying letter or resume is true and complete. I authorize investigation of all statements contained in this application including contacting past employers regarding work record. I release and hold harmless and promise not to claim damages from any of my prior employers listed above who have provided information. I understand that misrepresentation or omission of facts called for is cause for dismissal. Further, I understand and agree that my employment is for no definite period and may, regardless of the date of payment of wages and salary, be terminated at any time without any previous notice. I agree to submit to any drug or alcohol testing that may be required by the employer for my hire or continued employment. I understand that refusal to take such tests may be cause for denial of employment or termination. I also understand that employment may be conditional upon an investigation into any criminal conviction on record with local, state, or federal law enforcement authorities. I understand this application is not a contract.

You will be asked to sign and date application if you are called for an interview.

Applications are void after 60 days.

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Employment Application

Personal Information

Employment Desired