Fill out the Employee Application below and bring the completed Drug Screening and Consent forms to your interview. Drug Screening PDF Consent Form PDF I verify that the information that I have provided is true(Required) Yes Personal InformationName(Required) First Last Address Street Address City StateAlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email PhoneDate of Birth(Required) Month Day Year Work InformationPosition Applying For How did you hear about us? Desired Wages When can you start? Are you a US citizen or otherwise authorized to work in the US on an unrestricted basis?(Required) Yes No Are you available nights and weekends? If no, what hours are you available? Yes No Other Have you ever been convicted of a felony? If so, please give details here. Yes No Other Employment HistoryIn addition to your work history, are there are other skills, qualifications, or experience we should consider?Company 1 Please list prior employment below starting with most recent first.Company Name Address PhoneName of Supervisor Date Started Month Day Year Date Ended Month Day Year Starting Wage Ending Wage Starting Position Ending Position ResponsibilitiesReason for LeavingMay We Contact? Yes No Company 2 Please list prior employment below starting with most recent first.Company Name Address PhoneName of Supervisor Date Started Month Day Year Date Ended Month Day Year Starting Wage Ending Wage Starting Position Ending Position ResponsibilitiesReason for LeavingMay We Contact? Yes No Company 3 Please list prior employment below starting with most recent first.Company Name Address PhoneName of Supervisor Date Started Month Day Year Date Ended Month Day Year Starting Wage Ending Wage Starting Position Ending Position ResponsibilitiesReason for LeavingMay We Contact? Yes No Business References (Please provide three.)Reference 1Reference Name Business Name Email PhoneReference 2Reference Name Business Name Email PhoneReference 3Reference Name Business Name Email PhoneBusiness References (Must provide one.)Reference Name Email PhoneOther InformationPlease list any other information that may be helpful here:Drug Screening Consent FormWill You Consent to a Drug Screening? Yes No Please print and bring the completed Drug Screening and Consent forms to your interview. Drug Screening PDFConsent Form PDFBackground Check ConsentWill You Consent To A Background Check? Yes No I certify that the facts set forth in this application for employment are true and complete to the best of my knowledge. I understand that if I am employed, false statements on this application shall be considered sufficient cause for dismissal. This company is hereby authorized to make any investigations of my prior educational and employment history. I understand that employment at this company is “at will,” which means that either I or this company can terminate the employment relationship at any time, with or without prior notice, and for any reason not prohibited by statute. All employment will continue on that basis.By submitting this form, I give permission to LG Cleaning to check and verify my information.CAPTCHA
