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Application For Employment

MOBIL MAID
71 CANAL ST.
CHESTER, VT 05143
(802) 875-099

Welcome to Mobil Maid! We are an equal opportunity employer, which means that your application for employment will be considered without regard to race, religion, color, national origin, gender, marital status, disability, or age.

The first step in the hiring process is completion of the following employment application. By signing and submitting this application, you will confirm that you seek employment with Mobile Maid and that all statements made in the application are true. In accordance with the law, this employment application is confidential, but information on the application may be disclosed to the extent necessary to verify the statements. Filling out this application does not create an employment relationship between Mobil Maid and you.

Name:

Date:

Address:

City, State:

Zip:

Telephone:

Social Security #:

Birthday:

Position Desired:

Do you have housekeeping experience?

If so please list:

PREVIOUS EMPLOYMENT

PLEASE NOTE: GAPS IN EMPLOYMENT HISTORY MUST BE JUSTIFIED
PLEASE CONTINUE ON ONE ADDITIONAL SHEET IF NEEDED

Most recent position:

Company:

Telephone:

Salary:

Reason For Leaving:

Responsibilities:

Superviser:

Okay To Contact:

Previous position:

Company:

Telephone:

Salary:

Reason For Leaving:

Responsibilities:

Superviser:

Okay To Contact:

Previous position:

Company:

Telephone:

Salary:

Reason For Leaving:

Responsibilities:

Superviser:

Okay To Contact:

EDUCATION & TRAINING

High School:

Grade Completed:

College Graduate:

Degree:

Other Education:

PERSONAL REFERENCES

1) Name/Title:

Address:

Phone:

Relationship:

2)
Name/Title:

Address:

Phone:

Relationship:

3)
Name/Title:

Address:

Phone:

Relationship:

4)
Name/Title:

Address:

Phone:

Relationship:

PLEASE ANSWER THE FOLLOWING QUESTIONS

1) Have you ever been fired from a job for cause?

If so, why?

2) Will you be able to perform the job juctions descriped?

If not, why?

3) Are you allowed by law to work in the United States?

If not, why?

4) Have you ever handled money or held a position of trust?

Describe:

5) Have you ever been convictedof a felonyor a crime?

6) Are you bondable?

7) Do you have a validdrivers license?

Drivers License Nr.

Do you certify that the information contained in this application is true and complete to the best of your knowledge and understand that any false information on this application may be grounds for not being hired?

Date Signed:

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