Application For Employment - A Clean Getaway

Position Applying for: *

Name *

First

Last

Street Address *

Email

Home Phone

Cell Phone *

Date You Can Start Work *

Salary Desired

High School Diploma / GED?

Yes
No
Current Student

Do you possess a valid driver's license? *

Yes
No

State Issued *

Do you currently have valid auto insurance? *

Yes
No

Will you have regular access to a reliable vehicle for work-related travel? *

Yes
No

Are you committed to practicing safe driving habits and adhering to all relevant traffic laws while using a company vehicle or personal vehicle for work-related purposes? *

Yes
No

Full or Part Time? *

Full Time
Part Time

Regular Or Temporary *

Regular
Temporary

Are you authorized to work in the U.S. on an unrestricted basis? *

Yes
No

Qualifications

High School

Qualifications

Degrees, Vocational, Technical Programs, or Military Training

Special Skills

Reference 1 *

Reference 2 *

Reference 3 *

Work History 1 *

Work History 2

Work History 3

Work History 4

Signature *

Please type your Full Legal Name in box above to verify your responses above are true to the best of your knowledge.