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APPLICATION FOR EMPLOYMENT
Application for Employment (CRC)
State
*
MD
NY
OH
PA
City
*
Personal Information
Full Name
*
Location Desired
*
Address
*
Position Desired
*
Customer Service Associate
Team Leader
Brand Ambassador
City/State
Salary Desired
*
Zip Code
Desired Status
*
Full-time
Part-time
Temp/Seasonal
Phone No
At least 18 years old?
*
Yes
No
Email
Able to work nights?
*
Yes
No
PLEASE INDICATE THE HOURS YOU ARE AVAILABLE TO WORK
Sunday
*
Any
12 AM to 8 AM
8 AM to 4 PM
4 PM to 12 AM
Monday
*
Any
12 AM to 8 AM
8 AM to 4 PM
4 PM to 12 AM
Tuesday
*
Any
12 AM to 8 AM
8 AM to 4 PM
4 PM to 12 AM
Wednesday
*
Any
12 AM to 8 AM
8 AM to 4 PM
4 PM to 12 AM
Thursday
*
Any
12 AM to 8 AM
8 AM to 4 PM
4 PM to 12 AM
Friday
*
Any
12 AM to 8 AM
8 AM to 4 PM
4 PM to 12 AM
Saturday
*
Any
12 AM to 8 AM
8 AM to 4 PM
4 PM to 12 AM
Have you ever worked for Clean Rite Center in the past?
*
Yes
No
If YES, please indicate dates of employment and store location
*
Dates
Location
*
Have you ever applied for a position with Clean Rite Center in the past?
*
Yes
No
If YES, please indicate dates of application and store location
*
Dates
Location
Do you have any relatives currently employed by Clean Rite Center?
*
Yes
No
If YES, please indicate name, titles and store location
*
Name/Title
Location
*
Work Experience
List previous experience beginning with current or most recent position
Company
From
To
Address
Starting Position
City/State
Last Position
Phone No
Supervisor Name/Title
Status
Full-time
Part-time
Temp
Reason for Leaving
May we contact this employer?
Yes
No
Company
From
To
Address
Starting Position
City/State
Last Position
Phone No
Supervisor Name/Title
Status
Full-time
Part-time
Temp
Reason for Leaving
May we contact this employer?
Yes
No
Company
From
To
Address
Starting Position
City/State
Last Position
Phone No
Supervisor Name/Title
Status
Full-time
Part-time
Temp
Reason for Leaving
May we contact this employer?
Yes
No
Professional References
Please provide two business or professional references. Do not list relatives.
Name and Title
*
REFERENCE #1
Name and Title
*
REFERENCE #2
Phone No
*
REFERENCE #1
Phone No
*
REFERENCE #2
How are you aquainted
*
REFERENCE #1
How are you aquainted
*
REFERENCE #2
Length of time aquainted
*
REFERENCE #1
Length of time aquainted
*
REFERENCE #2
Education and Training
Institution
HIGH SCHOOL
Institution
COLLEGE
Institution
ADDITIONAL TRAINING
Years Completed
HIGH SCHOOL
Years Completed
COLLEGE
Years Completed
ADDITIONAL TRAINING
Degree Program
HIGH SCHOOL
Degree Program
COLLEGE
Degree Program
ADDITIONAL TRAINING
Did you graduate?
HIGH SCHOOL
Did you graduate?
COLLEGE
Did you graduate?
ADDITIONAL TRAINING
Referral Source
*
Walk-In Applicant
Internet Ad
Workforce Referral
Employee Referral
Other
Employee Name
*
Additional Personal Information
Will you be engaged in other business or employment if employed by Clean Rite Center?
*
Yes
No
If YES, please indicate the nature of business and nature of work
*
Details
Permission to Work
All hires are required to provide proof of identity and legal authorization to work in the United States
Are you legally authorized for employment in the United States?
Yes
No
Applicant Certification and Authorization
IMPORTANT: CAREFULLY READ THE FOLLOWING INFORMATION BEFORE SIGNING
Signature of Applicant
*
Clear
I certify that the facts set forth in my application for employment are true and complete. I understand that if employed, false or incomplete statements or any misleading or incorrect information given on this application shall be considered sufficient cause for dismissal. I authorize Clean Rite Center to contact any of my previous employers, as well as any other credit or reference source in order to verify facts and information that I have furnished regarding my qualifications. I hereby release from liability all persons and organizations furnishing references or other information. I understand that the completion of this application is not to be construed as an express or implied contract of employment or guarantee leading to employment. I understand that completion of this application does not mean that there is an available position, and that use of this application in no way obligates Clean Rite Center. Furthermore, I understand that my term of employment, if hired, shall be for no definite period and shall be at-will. I acknowledge that no employee of the company other than the President of Clean Rite Center has any authority to enter into employment contracts. I understand that this application for employment will be considered active for 60 days from the date it is submitted, and that after this time a new application must be completed.
If you are human, leave this field blank.
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