OZGLO Cleaning Company, LLC

Application for Employment
PERSONAL INFORMATION    
FIRST NAME
 MIDDLE NAME :
 LAST NAME:
PRESENT ADDRESS:
 APT#:
 CITY:
 STATE :
ZIP CODE:
HOME PHONE:
 WORK PHONE:
 E-MAIL ADDRESS, IF APPLICABLE:
 DATE OF BIRTH:
HAVE YOU EVER BEEN EMPLOYED BY THIS COMPANY IN THE PAST?

Yes No

 IF YES, GIVE DATES OF EMPLOYMENT:

DO ANY OF YOUR RELATIVES WORK FOR THIS COMPANY?

Yes No

 IF YES, GIVE DATES OF EMPLOYMENT:

HAVE YOU EVER BEEN CONVICTED OF A FELONY?

Yes No

 IF YES, STATE THE NATURE OF THE OFFENSE, WHERE AND WHEN IT OCCURRED, AND THE SENTENCE IMPOSED:

HAVE YOU EVER BEEN CONVICTED OF A MISDEMEANOR WITHIN THE PAST SEVEN YEARS? (DO NOT INCLUDE CONVICTIONS FOR SPEEDING OR OTHER MINOR TRAFFIC VIOLATIONS)

YES NO IF YES, PLEASE EXPLAIN: (A felony or misdemeanor conviction will not necessarily exclude you from employment)
HOW DID YOU LEARN OF THIS POSITION? (check all that apply)
NEWSPAPER AD COLLEGE/SCHOOL REFFERRAL (Name: )
EMPLOYMENT AGENCY WALK-IN OR UNSOLICITED RESUME INTERNET JOB POSTING
OTHER:
 
 
EMPLOYMENT DESIRED  
POSITION APPLYING FOR:

WHEN ARE YOU ABLE TO START?

/ /

WAGE/SALARY DESIRED

$ PER HR. (LOW) TO $ PER HR. (HIGH)

ARE YOU APPLYING FOR?

FULL TIME PART TIME

ARE YOU AVAILABLE TO WORK A MINIMUM OF 20 HOURS PER WEEK?

YES NO
CHECK HERE IF YOUR HOURS ARE FLEXIBLE (ON OCCASION, YOU ARE AVAILABLE FOR WORK ANY DAY, A.M. OR P.M.)
SPECIAL NOTE: OZGLO’s REGULARLY SCHEDULED HOURS ARE USUALLY 7- 11 P.M.

HOURS AVAILABLE:

At the right, please indicate the days you are available to work.

SUN

MON

TUE

WED

THU

FRI

SAT
 
VEHICLES  

THE POSITION FOR WHICH YOU ARE APPLYING REQUIRES OWN VEHICLE AND/OR REQUIRES
THE OPERATION OF A COMPANY-OWNED VEHICLE. APPLICANTS MUST MAINTAIN VALID AUTO INSURANCE.
 
DO YOU HAVE A VALID DRIVER’S LICENSE?

YES NO

 IF YES, WHAT STATE WAS IT ISSUED?

DRIVER’S LICENSE NUMBER:

EXP. DATE

HAVE YOU HAD ANY TRAFFIC RELATED VIOLATIONS
OR CONVICTIONS?

YES NO

 IF YES, PLEASE EXPLAIN:

WHAT IS THE NAME OF YOUR AUTO INSURANCE PROVIDER?

GEICO PROGRESSIVE ALLSTATE AIG NATIONWIDE STATE FARM OTHER (SPECIFY)

 
WORK EXPERIENCE  

PLEASE LIST YOUR LAST THREE EMPLOYERS BEGINNING WITH THE MOST RECENT.
1. NAME OF EMPLOYER:

TYPE OF BUSINESS:

PHONE: (IF KNOWN)

CITY/TOWN OF BUSINESS:

STATE:

WAGE/SALARY:

$

YOUR POSITION:

EMPLOYMENT TIMEFRAME:

FROM: TO

EMPLOYED:

FULL TIME

PART TIME

TEMPORARY

REASON FOR LEAVING:
2. NAME OF EMPLOYER:

TYPE OF BUSINESS:

PHONE: (IF KNOWN)

CITY/TOWN OF BUSINESS:

STATE:

WAGE/SALARY:

$

YOUR POSITION:

EMPLOYMENT TIMEFRAME:

FROM: TO

EMPLOYED:

FULL TIME

PART TIME

TEMPORARY

REASON FOR LEAVING:
3. NAME OF EMPLOYER:

TYPE OF BUSINESS:

PHONE: (IF KNOWN)

CITY/TOWN OF BUSINESS:

STATE:

WAGE/SALARY:

$

YOUR POSITION:

EMPLOYMENT TIMEFRAME:

FROM: TO

EMPLOYED:

FULL TIME

PART TIME

TEMPORARY

REASON FOR LEAVING:
 
ADDITIONAL SKILLS  

IN THE SPACE BELOW, PLEASE INDICATE ANY OTHER SKILLS YOU WOULD LIKE THE COMPANY TO KNOW.
 
 
EDUCATION  

IN THE SPACE BELOW, PLEASE INDICATE ANY OTHER SKILLS YOU WOULD LIKE THE COMPANY TO KNOW.
LEVEL NAME AND LOCATION OF SCHOOL RECOGNITION OF COMPLETION
HIGH SCHOOL DIPLOMA?

YES NO

VOCATIONAL, TECHNICAL, OR OTHER SCHOOL CERTIFICATE?

YES NO

COLLEGE: SOME COLLEGE UNDERGRADUATE DEGREE CURRENTLY PURSUING
GRADUATE DEGREE SOME COLLEGE UNDERGRADUATE DEGREE CURRENTLY PURSUING
 
 
REFERENCES  

PLEASE LIST THE NAMES OF THREE PERSONS WHOM YOU HAVE KNOW FOR AT LEAST TWO YEARS.

DO NOT INCLUDE RELATIVES

1. NAME:

ADDRESS:

POSITION/PROFESSION

YEARS ACQAUINTED:

PHONE:

2. NAME:

ADDRESS:

POSITION/PROFESSION

YEARS ACQAUINTED:

PHONE:

3. NAME:

ADDRESS:

POSITION/PROFESSION

YEARS ACQAUINTED:

PHONE:
 
 
DECLARATION: PLEASE READ AND SIGN  
  1. I DECLARE THAT ALL STATEMENTS AND ANSWERS IN THIS APPLICATION ARE TRUE AND COMPLETE IN ALL RESPECTS. I ACKNOWLEDGE AND AGREE THAT ANY FALSE STATEMENT, MISLEADING ANSWER, OMISSION, CONCEALMENT, OR FAILURE TO ANSWER ANY QUESTION FULLY, COMPLETELY AND ACCURATELY WILL BE GROUNDS FOR TERMINATING MY EMPLOYMENT IRRESPECTIVE OF WHEN THE INFORMATION IS DISCOVERED.
  2. I AUTHORIZE OZGLO CLEANING COMPANY, LLC OR AN OZGLO CLEANING COMPANY, LLC AGENT, AT ANY TIME PRIOR TO OR DURING MY EMPLOYMENT, TO: A) INVESTIGATE MY REFERENCES; B) COMMUNICATE WITH MY FORMER EMPLOYERS; C) CONDUCT AN INDEPENDENT INVESTIGATION OF MY CHARACTER, CONDUCT AND EMPLOYEMNT RECORD, INCLUDING, WITHOUT LIMITATION, A CRIMINAL BACKGROUND AND/OR SUBSTANCE ABUSE CHECK. I UNDERSTAND THAT THE RESULTS OF INVESTIGATIONS OR BACKGROUND CHECKS MAY BE KEPT AND PRESERVED.
  3. IF EMPLOYED, I AGREE TO READ THE EMPLOYEE HANDBOOK AND COMPLY WITH ALL COMPANY RULES, REGULATIONS AND POLICIES WHETHER SET FORTH IN THE EMPLOYEE HANDBOOK OR OTHERWISE.

SIGNATURE OF APPLICANT
DATE
 

 

 

Thank you for your interest in our Company!