Application Form Sex Male Female Interested in: Days Afternoons Evenings Wants to work: Full time Part time Interested in advancement opportunities: Yes No PERSONAL INFORMATION:Name(Required) First Middle Initial Last Maiden NameSocial security number needed AFTER you are officially hired: You will be required, after you are hired. You will also be required to bring your social security card to be copied for your file, photo ID and/or License, proof of car insurance.Present Address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Mailing Address if not the same as above Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Cell / Home PhoneHow long does it take for you to drive to the Lewiston area (minutes)?Are you 18 years or older? Yes No We do background checks on newly hired employees. Is it ok to run a background check on you? Yes No Have you EVER had a background check done on you in the past? Yes No If yes, could we please have a copy of the background check? Yes No If no, reason why?Which state were you born in?Which state(s) did you grow up in?LICENSE:Do you have a valide Maine Driver's Lisence? Yes No If no, which state is it from?Do you own a vehicle? Yes No Do you have car insurance? Yes No Email EDUCATION:Name of High School:Years attended:Did you graduate? Yes No If you did not graduate, did you get a GED? Yes No If you do not have a GED are you planning on getting one, and if yes, when?COLLEGE:Name of College:Major:Did you graduate? Yes No If no, how long did you attend?Reason for not finishing/returning to college?DESIRED EMPLOYMENT:Which area are you applying for? Lewiston/ Auburn Lisbon/ Sabattus Falmouth Portland Yarmouth Have you ever applied with our company before? Yes No If yes, when did you last apply?Did you work for us in the past? Yes No If yes, when did you last work with us?This position is Monday - Friday. Does that schedule work for you? Yes No Are you available to work with a group on weekends? Yes No Which days? Saturdays Sundays Both Which shifts are you applying for? Days (7:00am - 5:00pm) Afternoons (1:00pm - 7:00pm) Or Nights (5:30pm until around 11:30 - midnight) Date you can start if hired: MM slash DD slash YYYY Desired Salery:You will receive an evaluation on your performance, attendance, attitude, cleaning, getting along with others, etc, within 2-4 weeks after you start, if things are going well you will receive your first raise at your one year anniversary, if performance continues to be good all of those items then you will receive an increase every year on your anniversary date. If you apply for a promotion, you will receive your increase at the time your promotion is approved.Number of hours you are looking for?Part time would be 25-29 hours, full time is 30-40 hours. Overtime is considers over 40 hours.Who referred you to this company? Employment/Temp agency Newspaper Ad/Sun Journal Friend Career Center Walk In Facebook If friend, name:If other, explain:EMPLOYMENT HISTORY:Are you currently working? Yes No If no, how long have you been out of work? (months, years)How much time did you miss and/or were out sick and/or for personal reasons from your last job?Name of PRESENT/or CURRENT/ or Last Employer:Company Name:Company Adress:Start Date of this job: MM slash DD slash YYYY Hourly rate of Pay: $Job Title:If done, reason why?Select one: Terminated Laid off due to lack of work Gave a notice Quit with no notice Other:Supervisor's Name:Supervisor's Phone Number:Name of previous employer to one written above:Company Name:Company Adress:Start Date of this job: MM slash DD slash YYYY End Date of this job: MM slash DD slash YYYY Job Title:Supervisor's Name:May we contact them? Yes No Company's Phone Number:If done, reason why?Select one: Terminated Laid off due to lack of work Gave a notice Quit with no notice Other:Name of previous employer to one written above:Company Name:Company Adress:Start Date of this job: MM slash DD slash YYYY End Date of this job: MM slash DD slash YYYY Job Title:Supervisor's Name:May we contact them? Yes No Company's Phone Number:If done, reason why?Select one: Terminated Laid off due to lack of work Gave a notice Quit with no notice Other:REFERENES:1 family member only, 2 non-family: example/friend, previous employers/ managers/ supervisors are ok to list?Name First Last PhoneRelationYears Known:Name First Last PhoneRelationYears Known:Name First Last PhoneRelationYears Known:Name First Last PhoneRelationYears Known:IF YOU ARE HIRED WE NEED THE NAME & PHONE NUMBER OF A PERSON TO CONTACT IN CASE OF EMERGENCY:Name First Last RelationPhonePlease list any special hobbies, skills or training, things you like to do, it doesn't have to be cleaning related:Have you ever served in the military? Yes No Branch Service:Discharge Date: MM slash DD slash YYYY This job requires a person to wear a backpack vacuum cleaner on their back up to 4-5 hours at a time, are you able to do this? Yes No Our company does require this and it is mandatory.If you are unable to wear one, please explain why?Have you worn one before? Yes No This job also requires standing/walking for long periods of time, 5-6hours per shift, is this something youa re able to do? Yes No If you are unable to, please explain why?I certify that the facts contained in this application are true & 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 & the references and employers listed above to give you any and all information concerning my previous employment, and any pertinent information they may have, personal or otherwise, and released the company from all liability for any damage that may result from utilization of such information. I understand an agree that no representative of the company has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the forgoing, unless it is in writing and signed by an authorized company representative.Today's Date: MM slash DD slash YYYY Print your name for signature First Last CAPTCHA Δ
