Employment Opportunities – South Central PA "*" indicates required fields Name* First Last Phone*Email* Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Employment EligibilityReferred ByWhat position are you applying for?*Are you legally eligible to work in the United States?* Yes No Have you ever been convicted of a crime?* Yes No List the charge and the ruling*Do you have a current driver's license?* Yes No Do you have a reliable car for transportation?* Yes No Choose Pro Quality office* South Central PA Southeastern PA Central VA When are you available to start?*When are you available for work?* 1st shift 2nd shift 3rd shift Days* Monday Tuesday Wednesday Thursday Friday Saturday Sunday EducationHigh School Name / Location*Highest Grade CompletedCollege Name / LocationHighest Degree ObtainedOther Training or Comments? Yes Provide details here*ExperiencePlease select all that apply Office cleaning experience Floor stripping and waxing experience Carpet cleaning experience Supervision/management experience Other experience or comments? Yes Provide details here*Employer 1 (required)Employer*From*To*Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Supervisor*Phone*Wage/Salary*Position Held*Work Performed*Reason for Leaving*Employer 2EmployerFromToAddress Street Address Address Line 2 City State / Province / Region ZIP / Postal Code SupervisorPhoneWage/SalaryPosition HeldWork PerformedReason for LeavingEmployer 3EmployerFromToAddress Street Address Address Line 2 City State / Province / Region ZIP / Postal Code SupervisorPhoneWage/SalaryPosition HeldWork PerformedReason for LeavingOther QuestionsIf hired, are you willing to submit to a drug test?* Yes No If hired, are you willing to submit to a background check?* Yes No Are you able to lift or push up to 45 pounds without accommodation?* Yes No Are there any physical limitations that you cannot perform?* Yes No If so, please explainReferencesPlease include work-related references onlyReference 1 Name*How do you know this person?PhoneReference 2 NameHow do you know this person?PhoneAuthorizationElectronic Signature*Date* MM slash DD slash YYYY Cell Phone NumberConsent* I agree to the privacy policy.I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, false statements on this application shall be grounds for dismissal. I authorize Carter's Pro Quality Cleaning to contact any of my prior employers listed above. I also expressly release those prior employers and Carter's Pro Quality Cleaning from any and all liability arising from their giving the information about my employment history. I authorize investigation and verification of all statements contained in this application.
