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Please provide the following contact information:

APPLICANT NAME
Street Address
City
Preferred Phone
E-mail
DATE OF BIRTH
Driver's License #
Driver's License State
Present Employer
Employer Telephone#
Employer City
Current Position
Supervisor
Employed Since
Gross Monthly Salary
 Previous Employer
Previous Employer Telephone
Previous Employer City
Previous Employment Position
Previous Employer Supervisor
Previous Employment Dates:
Previous Employer Gross Salary
Reference #1
Telephone #
Reference #2
Telephone #
Reference #3
Telephone #

  HAVE YOU EVER BEEN CONVICTED OF ANY CRIME (misdemeanor or felony) OR SEX CRIME OR ARE YOU REQUIRED TO REGISTER AS A SEX OFFENDER?   If, yes, please explain:

Applicant hereby authorizes Clements Cleaning to make any inquiries it deems necessary in the establishment of Applicant's credit rating and/or other information and references. Applicant further authorizes the references listed herein to relay to Clements Cleaning any information they require.  Applicant understands submission of application is no guarantee or offer of employment. 


By typing your name (s) in the box (s) below, you agree that the information provided by you or on your behalf is accurate and reliable and authorize Clements Cleaning to verify the validity of provided information. 

Background checks and drug testing will be conducted prior to offer of employment and prior to any start date.  Additonal Background checks & drug testing will be completed randomly thereafter. Do not submit an application if you think you will fail either.

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Question/Comments:

   

Upon submitting, your information will be forwarded to the proper department.  We will be in touch shortly.  No phone calls please. 

 
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