Online Job Application – Connected Cleaning Group

Name *

First

Last

Email *

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Phone

Date Available *

Social Security No *

Desired Salary($) *

Position Applied for *

Are you a citizen of the United States? *

Yes
No

Have you ever worked for this company? *

Yes
No

Have you ever been convicted of a felony? *

Yes
No

Are you authorized to work in the U.S.? *

Yes
No

If no, please explain

High School

From

To

Did you graduate?

Yes
No

Diploma

College

From

To

Degree

References

First Refree

Name *

First

Last

Email *

Phone

Relationship *

Second

Name *

First

Last

Email *

Phone

Relationship *

Previous Employment

Last Employment

Company

Phone

Supervisor Name

Job Title

Starting Salary

Ending Salary

Responsibilities

From

To

Reason for Leaving

May we contact your previous supervisor for a reference?

Yes
No

Previous Employments

Company

Phone

Supervisor Name

Job Title

Starting Salary

From

To

Ending Salary

Responsibilities

Reason for Leaving

May we contact your previous supervisor for a reference?

Yes
No

Military Service

If you not part of Military service please press next button.

Branch

From

To

Rank at Discharge

Type of Discharge

If other than honorable, explain

Background Authorization

The information contained in this application is correct to the best of my knowledge.

I hereby authorize Connected Cleaning Group and its designated agents and representatives to conduct a comprehensive review of my background causing a consumer report and/or an investigative consumer report to be generated for employment and/or volunteer purposes. I understand that the scope of the consumer report/ investigative consumer report may include, but is not limited to the following areas: verification of social security number; credit reports, current and previous residences; employment history, education background, character references; drug testing, civil and criminal history records from any criminal justice agency in any or all federal, state, county jurisdictions; driving records, birth records, and any other public records.

I further authorize any individual, company, firm, corporation, or public agency to divulge any and all information, verbal or written, pertaining to me, to Connected Cleaning Group or its agents.

I further authorize the complete release of any records or data pertaining to me which the individual, company, firm, corporation, or public agency may have, to include information or data received from other sources. Connected Cleaning Group and its designated agents and representatives shall maintain all information received from this authorization in a confidential manner in order to protect the applicant’s personal information, including, but not limited to, addresses, social security numbers, and dates of birth.

Disclaimer

I certify that my answers are true and complete to the best of my knowledge.

If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.

Date *

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