Aplique Aqui

Employment Form

Today's Date

Last Name

First Name

Middle Initial





Home Phone, Cell or Pager


Are you legally eligible to work in the United States?

 Yes No

Have you worked for us before?

 Yes No


Date you will be available to start work

Have you worked in maintenance

 Yes No


Have you ever been convicted of a felony

 Yes No

In what state?


Are you 18 years of age or older?

 Yes No


 Full time (7-8 hours days) Part time (6 or less hours a day)

Shift Desired

 Days Evenings Over Nights

What days are you unable to work?

What languages do you speak?

Indicate the fluency level


Employment References

May we contact your current employer?

 Yes No

Company Name



Dates of Employment

From (MM/YY)

To (MM/YY)

Name of Supervisor

Job Title


Reason For Leaving

Starting Salary

Ending Salary

This application will remain on active file for 60 days. If I am hired within this period, it will become part of my personnel file.

In consideration for employment with The Office Cleaners, if employed, I agree to conform to the rules, regulations, policies and procedures of The Office Cleaners at all times and understand that it is a condition of employment. I understand, due to the nature of The Office Cleaners business, attendance and punctuality are considered essential requirements of every job at The Office Cleaners and that poor attendance or tardiness will result in disciplinary action.

Any misrepresentation, falsification or significant omissions of information will be cause for rejection of my application or for subsequent discipline up to and including my dismissal from employment if discovered at a later date.

I herby agree to submit to any lawful drug or background check that may be required as a condition of employment or continued employment, and understand that the refusal to submit to such testing during the course of my employment may result in disciplinary action, up to and including dismissal.

I understand and agree that if I am employed, my employment and compensation are for no definite period and may be terminated at any time, with or without notice, and with or without cause, by The Office Cleaners or myself. No management official is authorized to make any oral assurance or promise of continued employment.

All information (including information on any accompanying resume) is subject to verification.

I authorize and consent to my current and prior employers, educational institutions, consumer reporting agencies and persons or organizations named in this application (or accompanying resume) to release any information to The Office Cleaners, and I release them from liability from damage in providing information that may be required to make an employment decision.

The Office Cleaners uses E-Verify to confirm employment eligibility.

An Equal Opportunity Employer

I have read the statement above and agree

 Yes No