EMPLOYMENT APPLICATION FORM

"*" indicates required fields

Name*

First Middle Last Maiden

Cell Phone*

Social security no.

Last 4 digits only

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Availability

How many hours can you work weekly?*

Pay rate desired per hour*

Any days/hours you are not available to work?*

When can you start?*

Education / Training

Education*

(Use the plus to add more)

Type of school (i.e., High School, College, Trade School)

Name of school

Years attended

Have you ever served in the armed forces?*

Yes

Specialty / dates

Additional Questions

Do you have a valid driver’s license?*

Yes

If hired, would you have a reliable means of transportation to/from work?*

Yes

Are you able to perform the essential job functions of the job for which you are applying with or without reasonable accommodation?*

Yes

Have you ever been convicted of a crime?*

Felony or misdemeanor

Yes

Please explain

Include offence(s), date(s), court, sentence(s), and rehabilitation completed. It is the policy of SKJ not to discriminate against applicants with a criminal record and is not an automatic bar to employment. Factors at the time of the offense such as age, seriousness, and nature of the violation and rehabilitation will be taken into account.

Remarks / additional information

Please use the space below for any additional information necessary to describe your qualifications for the position which you are applying.

Career

Professional references*

Please list 2 or more professional references (other than relatives) we can contact.
(Use the plus to add more)

Name

Phone

Relationship (i.e., coworker)

Work experience*

Please provide information on two prior work experiences beginning with the most recent.
(Use the plus to add more)

Employer name

Worksite address

Employer phone number & direct supervisor name

Job title

Employment dates

Reason for leaving

May we contact this employer? (Yes/No)

Authorization

I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for dismissal.
I authorize investigation of all statements contained herein and the references and employers listed to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release the company from all liability for any damage that may result from utilization of such information.
I also understand and agree that no representative of the company has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing, unless it is in writing and signed by an authorized company representative.
This waiver does not permit the release or use of disability-related or medical information in a manner prohibited by the Americans with Disabilities act (ADA) and other relevant federal and state laws.
I understand that a criminal record check or illegal drug screening may be necessary prior to my employment. If such reports are required, I understand that, in compliance with federal law, the company will provide me a written notice regarding the use of these reports and will also obtain a separate written authorization from me to consent to these reports. I understand that history of a criminal record will not automatically result in disqualification from employment. Factors at the time of the offense such as age, seriousness, and nature of the violation and rehabilitation will be taken into account.
In compliance with federal law, all persons hired will be required to verify identity and eligibility to work in the United States and to complete the required employment eligibility verification document form upon hire.

Hidden

Authorization

<ul>
    <li>I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for dismissal.</li>
    <li>I authorize investigation of all statements contained herein and the references and employers listed to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release the company from all liability for any damage that may result from utilization of such information.</li>
    <li>I also understand and agree that no representative of the company has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing, unless it is in writing and signed by an authorized company representative.</li>
    <li>This waiver does not permit the release or use of disability-related or medical information in a manner prohibited by the Americans with Disabilities act (ADA) and other relevant federal and state laws.</li>
    <li>I understand that a criminal record check or illegal drug screening may be necessary prior to my employment. If such reports are required, I understand that, in compliance with federal law, the company will provide me a written notice regarding the use of these reports and will also obtain a separate written authorization from me to consent to these reports. I understand that history of a criminal record will not automatically result in disqualification from employment. Factors at the time of the offense such as age, seriousness, and nature of the violation and rehabilitation will be taken into account.</li>
    <li>In compliance with federal law, all persons hired will be required to verify identity and eligibility to work in the United States and to complete the required employment eligibility verification document form upon hire.</li>
</ul>

Consent*

I certify, authorize and consent to the above.

SKJ Facilities Management, Inc is an equal employment opportunity employer providing janitorial and exterior maintenance services in New York. SKJ adhers to a policy of making employment decisions without regards to race, color, religion, sex, sexual orientation, national origin, citizenship, age, disability or any other protected status under federal, state, or local laws.

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