Step 1 of 2 50% Position(s) Desired* Personal InformationName* First Middle Last Address* Street Address Address Line 2 City 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 State Zip Code Email* Day Phone*Evening PhoneCell PhoneAre you 18 years of age or older?* Yes No Can you work an 8-hour shift without smoking?* Yes No ScheduleDate you can start working* MM slash DD slash YYYY Cannot work these days Sunday Monday Tuesday Wednesday Thursday Friday Saturday Cannot work these nights Sunday Monday Tuesday Wednesday Thursday Friday Saturday Other Restrictions EducationHigh School: Name City & State Area(s) of Study Graduated? Yes No College: Name City & State Area(s) of Study Graduated? Yes No Degree* Business or Trade School: Name City & State Area(s) of Study Graduated? Yes No Degree* Employment HistoryGive present or most recent position firstCompany Start Date MM slash DD slash YYYY End Date MM slash DD slash YYYY Address Street Address City State Position Rate of Pay Description of dutiesReason for leavingCompany Start Date MM slash DD slash YYYY End Date MM slash DD slash YYYY Address Street Address City State Position Rate of Pay Description of dutiesReason for leavingCompany Start Date MM slash DD slash YYYY End Date MM slash DD slash YYYY Address Street Address City State Position Rate of Pay Description of dutiesReason for leavingLegalAre you a U.S. Citizen?* Yes No Do you have a legal right & necessary documents to work in the U.S.?* Yes No Have you ever been convicted of a crime other than a minor traffic violation?* Yes No Please explain*Are there any felony charges pending against you?* Yes No Please explainAre we granted permission to check all above information* Yes No Any of the above employers you do not wish us to contact?Have you ever been discharged from any position?* Yes No Have you ever been employed by Baryames Cleaners before?* Yes No Dates* It is understood that any false or misleading statements on this application or failure to disclose material informations will be just cause for dismissal. I agree to undergo a character investigation at company expense. Further, I hearby release y former employers from all liability or damages on account of having furnished information regarding my personal character, habits, work record, etc. I further understand that upon acceptance of and continued employment with baryames Cleaners, Inc, I will agree to conform to the rules and policies of the company. My employment and compensation can be terminated, with or without cause and without notice at any time at the option of the company or by myself.Consent* I agree*
