Combat Cleanerz Employment Application   Please fill this out and submit online, or fax the completed application to: 570.796.2007 259 South Keyser Ave., Ste. 105  Old Forge, PA  18518
Full name:	* required
Social Security Number:	* required
Date of Birth:	* required
Do you have a permanent address?	* required
City:	* required
State:	* required
How long have you lived at this address?	* required
Do you plan on staying in the area for more than one year?	* required
Have you ever applied for a job with this company before?	* required
Have you ever worked with this company before?	* required
What hourly rate are you looking for?	* required
How were did you hear about us?	* required
Your Mailing Address:	* required
Mailing City:	* required
Mailing State:	* required
Mailing Zip Code:	* required
Email Address:	* required
When is the best time to call you?	* required
May we call you at work?	* required
Telephone #1 and type: (cell, home, work)	* required
Telephone #2 and type: (cell, home, work)
Driver's License (DL) Number:	* required
DL State:	* required
DL Expires:	* required
In case of emergency, whom shall we contact?
Telephone #:
Do you have all of the information required to fill out Form I-9? (see Form here)	* required
Do you have a reliable car?	* required
Can you work mid afternoon or evenings hours as well as the weekends?	* required
If need be, please explain:
Please detail any type of management experience you have had:
None:
Name, City and State of High School:	* required
Did you graduate?	* required
Do you have your Ged?	* required
Name, City and State of College:
Major:
Do you have your degree?
Semester hours completed:
Concentration:
Name, City and State of Trade School:
Did you complete the training?
What trade did you study?
Do you have any experience cleaning commercial buildings?
Please list your experience:
Have you any experience cleaning carpets?
Do you know about floor maintenance?
Do you have any experience being a supervisor in a service business?
Please detail your experience:
Name of Employer #1: (list present or last job here)	* required
Type of Business:	* required
Address:	* required
City:	* required
State:	* required
Zip Code:	* required
Phone:	* required
Starting and ending dates employed:	* required
Beginning and ending salary/wage:	* required
Full or part time?	* required
Name and title of Supervisor:	* required
May we contact?	* required
Please list the job's duties:
Why did you leave?
Name of Employer #2:	* required
Type of Business:	* required
Address:	* required
City:	* required
State:	* required
Zip Code:	* required
Phone:	* required
Starting and ending dated employed:	* required
Beginning and ending salary/wage:	* required
Full or part time?	* required
Name and title of Supervisor:	* required
May we contact?	* required
Please list the job's duties:
Why did you leave?
Name of Employer #3:	* required
Type of Business:	* required
Address:	* required
City:	* required
State:	* required
Zip Code:	* required
Phone:	* required
Starting and ending dates employed:	* required
Beginning and ending salary/wage:	* required
Full or part time?	* required
Name and Title of Supervisor:	* required
May we contact?	* required
Please list the job's duties:
Why did you leave?
Have you pleaded guilty, no contest to, or have been convicted of a felony or a lesser crime which involved theft, dishonesty, or violence in the past seven years?	* required
If so, describe the nature of the offense(s) and the county and state where convicted:
Have you had your driver's license suspended or revoked in the past five (5) years?	* required
If so, please describe the incident:
Have you ever been disciplined or fired by an employer in the past five (5) years?	* required
If so, please explain:
I hereby authorize Combat Cleanerz to investigate all statements made within this application, reviewing my driving and criminal records as well as the option to contact my previous employers.  I understand that any false statement(s) made herein may eliminate my application from employment consideration or if discovered after hire, may result in my discharge from employment. If hired I will conform to the policies, rules and refulations of Combat Cleanerz. If asked, I agree to submit to drug testing and I also agree to sign the "Non-Compete" agreement. I acknowledge that both my employment and my compensation can be terminated and/or changed at will, without prior notice and at the sole option of Combat Cleanerz.
Applicant's Signature:	* required
(dd/mm/year):	* required

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