PersonalName First Last Which Positions Are You Interested In?* 1st Shift Custodian- Full or Part Time 2nd Shift Custodian- Full or Part Time 3rd Shift Custodian Operations Manager (On-Site) Outside Sales Representative Site Supervisor General Maintenance Tech (On-Site) Permanent Address* Street Address Address Line 2 City State 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 ZIP Code Home PhoneCell Phone*Email* Date of Birth MM slash DD slash YYYY Do you have the legal right to live and work in the U.S.?* Yes No Other name(s) under which you have been previously employed Names of friends or relatives employed in this organization? Have you ever applied to this organization before?* Yes No If Yes, give date and position applied for Have you ever been employed by this organization before?* Yes No If yes, list dates of employment Do you have any family, business, health, or social restrictions or obligations that would prevent you from performing the job responsibilities?* Yes No Do you have any physical or mental condition or handicap which would endanger the health or safety of yourself and or others or that may affect your ability to perform the job(s) for which you are applying?* Yes No If yes, please describe such condition or handicap. Have you ever been convicted of a felony?* Yes No Convictions are not an automatic disqualification from employment.Will you comply with the safety work and attendance policies of our organization?* Yes No Employment InterestsDate Available To Start*Day12345678910111213141516171819202122232425262728293031Month123456789101112Year2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Type of Employment You Are Seeking:* Full Time Part Time Temporary What Days and Hours you are available to work? Do you have access to your own vehicle?* Skills pertaining to this position Painting Pressure Washing Hard Floor Tech Drywall Repair General Maintenance Electrical/Plumbing EducationWhere did you attend high school & college? (Click the + button to add a new row)*School Name & AddressMajorYears CompletedGPADegree/Diploma ReferencesList 3 professional references we may contact who are qualified to evaluate your capabilities. Do not include relatives. (Click the + button to add a new row)*NamePhoneCompany Employment HistoryGive employment record as completely as possible listing current or most recent employer first. Show unemployed or self-employed periods and indicate dates and comment on each period. Include part time or summer work.Company Name (Most Recent) Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code PhoneDates EmployedFromTo Job Title Supervisors Name & Title Type of Business Base Rate of Pay (Hour/Week/Month)StartEnd Description of dutiesReason for Leaving? May we contact this employer? Yes No Did you have another job before this one?* Yes No Company Name (Second Most Recent) Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code PhoneDates EmployedFromTo Job Title Supervisors Name & Title Type of Business Business Website Base Rate of Pay (Hour/Week/Month)StartEnd Description of dutiesReason for Leaving? May we contact this employer? Yes No Would you like to list another previous job? Yes No Company Name (Third Most Recent) Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands PhoneDates EmployedFromTo Job Title Supervisors Name & Title Type of Business Base Rate of Pay (Hour/Week/Month)StartEnd Description of dutiesReason for Leaving? May we contact this employer? Yes No Would you like to list a 4th job? Yes No Company Name (Fourth Most Recent) Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code PhoneDates EmployedFromTo Job Title Supervisors Name & Title Type of Business Base Rate of Pay (Hour/Week/Month)StartEnd Description of dutiesReason for Leaving? May we contact this employer? Yes No I agree to a Drug Screening at the company's expense.* Yes No I agree to a Criminal Background Check at the company's expense.* Yes No Sign Your ApplicationSigning this document states all information provided in this application is true to the best of your knowledge. Digital Signature: Printing your First Name + Middle Initial + Last Name will act as your digital signature.DateDay12345678910111213141516171819202122232425262728293031Month123456789101112Year2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Resume Upload (optional)Accepted file types: pdf, Max. file size: 512 MB.If you have a resume you'd like to attach, please do so here. This is not required. Must be a .pdf fileWould you like to add a cover letter? Yes No Cover Letter (optional)Accepted file types: pdf, Max. file size: 512 MB.Please upload your cover letter here. 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