Careers Form Step 1 of 3 33% Email* Date MM slash DD slash YYYY Position(s) applying for Desired Salary How were you referred to us? Advertisement Friend Relative Walk-in Agency Online Other If other, please explain Name* Phone*Address* Street Address City ZIP Code Prior Address (if present is less than 5 years) Street Address City ZIP Code Have you ever used another name for work or school? Yes No If yes, please state name and schools/employers Have you ever been employed by Apple Pest Control before? Yes No If yes, please indicate the dates Date you are available to begin work? MM slash DD slash YYYY Are you wiling to travel? Yes No Are you wiling to work flexible hours, which could include weekends and/or overtime? Yes No Do you plan to engage in other work while an employee at Apple Yes No If yes, please describe the work as well as the hours. Do you speak, read or write a language other than English? If so please specify Do you have any relatives that work for Apple Pest Control? If so please specify Criminal Convictions Criminal convictions do not automatically car consideration for employment. Factors such as age at time of conviction, length of time since offense, seriousness of offense and rehabilitation will be considered. Have you ever been convicted of a crime? Yes No If yes, please record below all misdemeanors and felonies (other than parking tickets and minor driving violations) for which you have been convicted. You may be asked to verify a criminal record. Please include year, location of conviction, and a description. (If no, type "n/a") Are you currently on probation or parole for any conviction? Yes No Are you able to preform the essential job functions of the position for which you are applying? Yes No ILLEGAL USE OF DRUGS AND MEDICAL EXAM. The job you are applying for requires reliable attendance and dependable performance during the work hours. If a contingent offer of employment is made, you will be asked to take a test for the current illegal use of drugs. If a conditional offer of employment is made you may be asked to take a job-related medical examination. Do you engage in the current illegal use of drugs (example: marijuana, cocaine, heroin, crack, speed, LSD, Etc.) Yes No Are you willing to be tested for the current illegal use of drugs? Yes No Have you ever been in the US military service? Yes No If yes please list branch, highest rank and nature of duty or training. Education Please list all schools, colleges, universities, specialized training programs attended: Type of school, address, graduation year, degree type or subject Licenses and Certifications Please list all professional or vocational licenses (real estate, plumbing, electrician, air conditioning, asbestos, hazardous substance, pest control applicator) or certifications (such as CAM, CAMT, CAPS, PLP, CPA, CHA OR CPM) that relate to the job for which you are applying. Type of license/certification, city, state agency or organization, date issues (if applicable), license number. Have you ever had a licenses or certification revoked or suspended? Yes No If yes, please explain If you are applying for a positions which involves driving on the job, please answer the following questions. Can you safely drive a vehicle? Yes No Do you have a valid, unexpired license? Yes No Has your license been revoked or suspended during the past five years? Yes No If yes, please explain Drive's license number, expiration date, issuing date, license class Please state any other information about your personal qualities, work skills or abilities which would assist us in considering you for the position you are applying for Personal References Please list two personal references. Do not list relatives or previous employers. Reference OneName and address Phone NumberYears Known Occupation Reference TwoName and address Phone NumberYears Known Occupation Employment History We routinely contact an applicant's current and previous employers for reference checks. Please attach a copy of any employment recommendation letters which can relate to the job you are applying for. Please provide your complete work history for the preceding five employers or past five years, whichever is greater.Are you currently employed? Yes No May we contact your current employer? Yes No If no, please explain: Current or most recent employer (please include volunteer work)Company name Company phone numberSupervisor's name and position Company address Street Address City ZIP / Postal Code Position Duties Reason for leaving Start date MM slash DD slash YYYY Last date MM slash DD slash YYYY Beginning salary Ending salary Additional information about position Authorization by Employment Applicant I authorize The "Company" and/or it's agents to: 1) obtain verification of any information provided by me in this employment application and in any supplemental questionnaire, exhibit, resume, or biographical sheet that I submit; 2) obtain information regarding my work habits, skills and conduct from my past and present employers, as well as listed or developed references or institutions; 3) obtain information from law enforcement and other governmental agencies, military authorities, and private companies concerning my conduct, including traffic and criminal convictions; 4) obtain information for educational institutions concerning my educational record, conduct and skills; and 5) obtain information concerning my credit history from credit reporting agencies, financial institutions, and other sources. I further authorize all institutions, agencies, companies, or persons referred to above, to provide The "Company" and/or its agents all information requested. Under the Federal Fair Credit Reporting Act, I understand that I will be so advised and given the name of the reporting agency for more information. I release The "Company" its agents and all other parties from an claims, liabilities, and damages resulting from obtaining or furnishing information. A copy of this authorization and release shall be as valid as the original. I understand that if I receive a conditional offer of employment, I will be asked to sign a separate authorization form prior to any testing for the current illegal use of drugs. I also understand that if I receive a conditional offer of employment, I may be asked to sign a separate authorization form prior to any job-related medical examination. Type your name to agree. Today's date MM slash DD slash YYYY Certification by Employment Applicant For purposed of this certification, the term "application" includes this employment application form and any supplemental questionnaire, exhibit, resume, or biographical sheet that I submit. I certify that all information given on this application is true, correct and complete. I have accounted for all of my work experience, training and other information requested on this application. I have not withheld any fact or circumstance which is covered by this application. I understand that any false, misleading or incomplete information will result in rejection of my application or termination of my employment whenever discovered. I understand that I may be asked to take a job-related written test and skill tests (if applicable) for the position for which I am applying. If I refuse to be tested, I understand that I will not be further considered for employment. I understand that after receiving a conditional offer of employment, I will be asked to submit to testing for the current illegal use of drugs by a firm that is chosen and paid for by The "Company." The results of such testing will be communicated to The "Company" or one of it's agents. If I refuse to be tested or if I produce a positive test result for the current illegal use of drugs, I understand that I will not be further considered for employment. I understand that after receiving a conditional offer of employment, I understand that I may be asked to have a job-related medical examination performed by a medical practitioner who is chosen and paid for by "The Company." The results of such examination will be communicated to The "Company" or it's agents. If I refuse to submit to a such job-related medical examination, I understand that I will not be further considered for employment. If I am employed, I understand that I will be asked to sign a Federal I-9 form and provide positive proof of my identity and verification on my right to live and work in the U.S.A. If I employed, I agree to abide by The "Company's" rules, procedures and polices as modified from time to time, including any drug-free work place policies. I understand that the job being applied for requires reliable attendance and dependable performance during the contemplated working hours. I understand if I am employed, I may be requires to work carious shifts and schedule as directed by my supervisor. I understand that any employment is subject to change in wages, conditions, benefits and operating policies. I agree that if I am offered a position, it will be offered on condition that my employment shall be at will and for definite period, and that my employment may be terminated at any time with or without cause and with or without prior notice. I understand that, except for the unanimous decision of the Executive Committee, no supervisor or management may alter or amend the above conditions. Only the unanimous decision of the Executive Committee of the "Company" has authority to enter into any agreement for employment for any specified period of time or to make any agreement contrary to the foregoing. I understand that this is an application only and that it does not constitute an offer of employment or employment contract.Type your name to confirm Today's date MM slash DD slash YYYY If you have any additional files to share for our consideration you may attach them here. (Recommendation letters, resume, etc.)If you have any additional files to share for our consideration you may attach them here. (Recommendation letters, resume, etc.)Max. file size: 50 MB.CommentsThis field is for validation purposes and should be left unchanged. Δ
