Meyers Cleaning, Business Cleaning, Residential Cleaining, Carpet Cleaning West Michigan

Meyer's Cleaning Online Employment Application - Part 1

	Basic Information
Full Name	*
Present Address	*
Apt. #
City	*
State	*
Zip	*
Email Address	*
Are 18 or older?	YES NO *
	Contact Information
Home Phone	*
Work Phone
Cell Phone
	Misc. Information (Optional)
Date of Birth	Month: Day: Year:
Marital Status

	All Items Marked With The Asterisk ( * ) are required to continue.

Meyer's Cleaning Online Employment Application - Part 2

Employment Information*

Desired Employment Position

Date You Can Start?

Expected Hourly Wage

Employed Currently?

YES NO If so, can we contact your current employer? YES NO

Who Referred You To Us?

How many hours a week are you interested in if available?

How many days / nights per week

Availability - Can You Work:

Early Mornings (5-6am)? YES NO Daytime? YES NO

Evenings after 5pm? YES NO Saturday's? YES NO

Education *

School Level	Name And Location	# of years	Graduate?	Subjects Studied
Grammar
High School
College
Trade, Business or Correspondence

Other Education

Subjects of Special Study or Research Work

Special Training

Special Skills

All Items Marked With The Asterisk ( * ) are required to continue.

Meyer's Cleaning Online Employment Application - Part 3

	Present Employer (or last) *
Employer Name
Present Address
City
State
Zip
Starting Date
Leaving Date
Job Title
Weekly Starting Salary	/week
Weekly Final Salary	/week
May We Contact Your Supervisor?	YES NO
Name of Supervisor
Title of Supervisor
Phone
Description of Work
Reason for Leaving
	Previous Employer *
Employer Name
Present Address
City
State
Zip
Starting Date
Leaving Date
Job Title
Weekly Starting Salary	/week
Weekly Final Salary	/week
May We Contact Your Supervisor?	YES NO
Name of Supervisor
Title
Phone
Description of Work
Reason for Leaving
	Previous Employer *
Employer Name
Present Address
City
State
Zip
Starting Date
Leaving Date
Job Title
Weekly Starting Salary	/week
Weekly Final Salary	/week
May We Contact Your Supervisor?	YES NO
Name of Supervisor
Title
Phone
Description of Work
Reason for Leaving

	All Items/Sections Marked With The Asterisk ( * ) are required to continue.

Meyer's Cleaning Online Employment Application - Part 4

Personal References *

Name	Address	Phone Number	Years Acquainted

Service Record

Branch of Service

Discharge Date

Notes:

Other

Have you been convicted of a felony within the last 5 years?	YES NO
If yes, please explain (will not necessarily exclude you from consideration)

All Items Marked With The Asterisk ( * ) are required to continue.

Meyer's Cleaning Online Employment Application - Part 5

Authorization

"I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for dismissal.

I authorize investigation of all statements contained herein and the references and employers listed above to give you any and all information concerning my previous employment and any pertinent information they have have, personal or otherwise and release the company from all liability for any damage that may result from utilization of such information.

I also understand and agree that no representative of the company has any authority to enter into any agreement for employement for any specified period of time, or to make any agreement contrary to the foregoing, unless it is in writing and signed by an authorized company representative."

In leiu of your signature, we ask for your digital signature as your agreement to the above authorization. This digital signature is binding and you must answer truthfully as it was any other part of this application.

Your Digital Signature: What is your mother's maiden name: *

All Items Marked With The Asterisk ( * ) are required to continue.