Employment Application

Please stop in to your nearest location or fill out this online application.

Fields marked with *are required

Name Name:* Date:* Social Sec. #: Date of Birth:

Address:*

City:* State:* Zip:*

Home Phone:* Cell Phone: Fax:

Email Address:* Drivers License #: State: Position Applying For: Are you legally eligible for employment in the U.S.? Yes No List anything that may be found when we perform a criminal background check: List any violation that we will find on a driving record search: When would you be available to begin work? List anything you consider to be your greatest achievements in life or past jobs: Have you ever worked on tall ladders? Yes No How did you hear about Squeegee Squad?

Education

	Name & Location	# of yrs	Graduate Date	Subjects studied
High School
College
Trade or business
Seminars, classes
Other

Subjects of special study or research work:

Military Service Military Service? Yes No

Years: Branch:

Employment History Please list previous employment including past five employers. Explain any gaps in employment below.

Employer	Location	Dates of hire
Duties	Reason for Leaving	Supervisor

Explanation for employment gaps:

References Please list three references that are not relatives.

Name	Telephone	Years Known	How are you acquainted?

Additional Information

Signature I certify that the information given is true and accurate to the best of my knowledge. Applicant Name:* Date:*

*Squeegee Squad is an Equal Opportunity Employer.

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Employment Application