Application For Employment

C&L Services Application for Employment
C&L Sweeper Service Corp is an equal opportunity employer and does not discriminate against otherwise qualified applicants on the basis of race, color, creed, religion, ancestry, age, sex, marital status, national origin, disability or handicap, or veteran status.
Name*
First Middle Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone*
Email*
Position Applying for*
- Full Time
- Part Time
Date Available
Are you over 21 years old?*
- Yes
- No
Are you legally eligible for employment in the United States?*
- Yes
- No
(If offered employment, you will be required to provide documentation to verify eligibility.)
Have you ever been employed in any facility of C&L Sweeper Service Corp?*
- Yes
- No
(A conviction will not necessarily automatically disqualify you for employment. Rather, such factors as age and date of conviction, seriousness and nature of the crime, and rehabilitation will be considered)
Address for the past three years
Address for the past three years
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
How Long?
Address for the past three years
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
How Long?
Physical History
List any handicap that prevents you from doing certain kinds of work
Do you have any pre-existing medical conditions we should be aware of? Please list...
Are you physically capable of heavy manual work? (i.e. 70 lbs or more)*
- Yes
- No
Ever injured on the job? Give nature and degree of such injuries:
How much time lost from work in past three years for illness?
Education
Please indicate education or training which you believe qualifies you for the position you are seeking
HIGH SCHOOL - Number of years completed (select one)
- 1
- 2
- 3
- 4
Diploma
- Yes
- No
G.E.D
- Yes
- No
Please list school(s) and location(s)
COLLEGE - Number of years completed (select one)
- 1
- 2
- 3
- 4
Please list school(s), major and/or degrees
OTHER TRAINING - Please list any other training, certificates or degrees
Professional License or Membership
(You need not disclose membership in professional organizations that may reveal information regarding race, color, creed, sex, religion, national origin, ancestry, age, disability, marital status, veteran status or any other protected status.)
Type of License(s) Held (Driver’s License, CDL, Etc.)
In what state are these licenses held?
License Number
License Expiration Date
Other Professional Membership
Have you ever been denied a license, permit or privilege to operate a motor vehicle?
- Yes
- No
Has any license, permit or privilege ever been suspended or revoked?
- Yes
- No
Date of last accident
What was the nature of that accident? (Head-on, Rear-end, Upset, Fatalities, Injuries)
Date of next previous accident
What was the nature of that accident? (Head-on, Rear-end, Upset, Fatalities, Injuries)
Date of next previous accident
What was the nature of that accident? (Head-on, Rear-end, Upset, Fatalities, Injuries)
Employment History
List last employer first, including U.S. Military Service
May we contact your present employer?
- Yes
- No
If any employment was under a different name, indicate name
Most Recent Employer
Phone
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Date of employment from
To
Position
Supervisor
First Last
Duties
Reason for leaving
Previous Employer
Phone
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Date of employment from
To
Position
Supervisor
First Last
Duties
Reason for leaving
Previous Employer
Phone
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Date of employment from
To
Position
Supervisor
First Last
Duties
Reason for leaving
APPLICANT'S CERTIFICATION AND AGREEMENT

By submitting this application, I hereby certify that the facts set forth in the above employment application are true and complete to the best of my knowledge and authorize C&L Sweeper Service Corp to verify their accuracy and to obtain reference information on my work performance.

I hereby release C&L Sweeper Service Corp from any/all liability of whatever kind and nature which, at any time, could result from obtaining and having an employment decision based on such information.

I understand that, if employed, falsified statements of any kind or omissions of facts called for on this application shall be considered sufficient basis for dismissal.

I understand that should an employment offer be extended to me and accepted that I will fully adhere to the policies, rules and regulations of employment of the Employer. However, I further understand that neither the policies, rules, regulations of employment or anything said during the interview process shall be deemed to constitute the terms of an implied employment contract.

I understand that any employment offered is for an indefinite duration and at will and that either I or the Employer may terminate my employment at any time with or without notice or cause.
Enter Your Legal Name to Acknowledge the Terms of The Employment Application

Application For Employment

C&L Services Application for Employment

(A conviction will not necessarily automatically disqualify you for employment. Rather, such factors as age and date of conviction, seriousness and nature of the crime, and rehabilitation will be considered)

Address for the past three years

Physical History

Education

Professional License or Membership

Employment History

APPLICANT'S CERTIFICATION AND AGREEMENT

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