Application English – Carpe Diem Cleaning

Name *

First

Last

Social Security Number

Email *

Home Phone Number

Cell Phone Number

Street Address *

City *

State *

Zip Code *

Date of Birth *

Are you legally authorized to work in the United States? *

Yes
No

Are you under 18? *

Yes
No

Have you ever been convicted of a crime? *

Yes
No

If YES, give date, place, offense, and outcome (Previous convictions do not necessarily disqualify an application from employment)

Position Desired *

How did you hear about this position? *

List Job skills and experience that apply for this job: *

Date Available *

Desired Salary *

Employment History - Employer Name

Employer Street Address

Employer City, State, and Zip Code

Job Title

Job Duties

Please Enter Your Start & Ending Dates

Supervisor's Name

Supervisor's Phone Number

May We Contact Your Employer?

Yes
No

Employment History - Employer Name (2)

Employer (2) Street Address

Employer (2) City, State, and Zip Code

Job Title

Job Duties

Please Enter Your Starting and Ending Dates

Supervisor's Name

Supervisor's Phone Number

May We Contact Your Employer

Yes
No

Personal Reference Name (1)

Personal Reference Address (1)

Personal Reference Phone (2)

Personal Reference Name (2)

Personal Reference Address (2)

Personal Reference Phone (2)

Type Full Name as Signature *

Please read carefully and sign Above: I certify that the information contained in this application is correct to the best of my knowledge, and I understand that any misstatement or omission of information is grounds for ending the hiring process or dismissal. I authorize verification of information provided on this application; and authorize references listed above to give all pertinent information; and release all parties from all liability for any damage that my result from furnishing same to Carpe Diem Cleaning, Inc. In consideration for my employment, I agree to conform to the rules and regulations of Carpe Diem Cleaning, Inc. I further agree that either I, or Carpe Diem Cleaning, Inc. may terminate employment with or without cause or with or without prior notice, at any time. Finally, I understand that no representative of the Carpe Diem Cleaning, Inc. other than an Executive Officer has the authority to enter into any agreement for employment for any specific period of time, or to otherwise alter the foregoing. Carpe Diem Cleaning, Inc is an Equal Employment Opportunity employer. We conduct all employment-related activities without regard to race, color, religion, gender, gender identity, marital status, age, disability, veteran status, sexual orientation, national origin, or other classification protected by applicable State or Federal employment discrimination laws. Carpe Diem Cleaning, Inc., welcomes diversity in the workplace.

CONSENT FOR CRIMINAL BACKGROUND CHECK - Type Full Name as Signature *

Your signature below authorizes Carpe Diem Cleaning and Criminal Information Services, Inc. to obtain information about you (if applicable) from various law enforcement agencies, courts, and corrections agencies.

Gender *

Male
Female

Current Address *

Other Names Used

Previous addresses in the past 7 years: *

Type Full Name as Signature *

Seize Your Clean Day!