Employee Application

Personal Information

Position applying for

Full TimePart Time

Have you previously worked for us?*
YesNo

Beginning Date*

Ending Date*

When are you available to start?*

Are you legally eligible for employment in the U.S.A?*
YesNo

Are you currently employed?*
YesNo

May we contact your current employer?*
YesNo

Have you been convictd of a felony within the last 7 years?* Conviction will not necessarily disqualify an applicant from employment
YesNo

Please briefly explain a little about your conviction.

Attach a Copy of Your Resume File types allowed: .doc, docx, .pdf

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Previous Employer #1

Please fill out the details for your most recent employer.

Company Name*

Beginning Date*

EndingDate*

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Previous Employer #2

Please fill out the details for your second most recent employer.

Company Name*

Beginning Date*

Ending Date*

Previous Employer #3

Please fill out the details for your second most recent employer.

Company Name*

Beginning Date*

Ending Date*

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Additional Information - Other Qualifications

Summarize special job-related skills and qualifications acquired from employment or other experience

Do you currently have a computer?*
YesNo

Do you currently have Microsoft Office? (Version 2013 or later)
YesNo

Are you capable of performing in a reasonable manner, with or without reasonable accommodation, the activities involved in the job or occupation for which you have applied?*
YesNo

References

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Review & Sign

All Fields

By submitting this form I agree with all of the following

I hereby give permission to contact the employers listed previously concerning my prior work conduct and experience.
I certify that the answers given here are true and complete to the best of my knowledge.
I authorize investigation of all statement contained in this application for employment as may be necessary in arriving at the employment decision.
This application for work shall be considered active for a period not to exceed 90 days. Any applicant wishing to be considered for employment beyond this time period should inquire as to whether or not applications are being accepted at that time. In the event of employment, I understand that false or misleading information given in my application or interview may result in discharge. I understand, also, that I am required to abide by all rules and regulations of this employer.
I also understand by filling out and submitting this form it does not guarantee employment.
I am aware that if the application process proceeds I will be required to supply Air Clear with my social security number for work eligibility verification purposes before I will be given any work to complete.

Electronic Signature

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