Employment Application – employment.schumanclean.com

Personal Information

First Name *

Middle Name *

Last Name *

Street Address *

City *

State *

Zip Code *

Home Phone *

Alternative Phone

Position Desired *

Expected Compensation *

What days and hours are you available to work *

If hired, can you provide documentation of your identity and eligibility for employment in the United States? *

Yes

No

If hired, you will be required to complete an I-9 form.

Have you ever been previously employed by Schuman? *

Yes

No

When were you employed by Schuman? *

What was your position? *

Education

Schools attended (check all that apply) *

High School

Name of High School

Location of High School

City/State

Number of Years Completed

Did you graduate?

Yes

No

Degree or Diploma Received/Course of Study

College

Name of College

Location of College

City/State

Number of Years Completed

Did you graduate?

Yes

No

Degree or Diploma Received/Course of Study

Trade School

Name of Trade School

Location of Trade School

City/State

Number of Years Completed

Did you graduate?

Yes

No

Degree or Diploma Received/Course of Study

Graduate School

Name of Graduate School

Location of Graduate School

City/State

Number of Years Completed

Did you graduate?

Yes

No

Degree or Diploma Received/Course of Study

Other School

Name of Other School

Location of Other School

City/State

Number of Years Completed

Did you graduate?

Yes

No

Degree or Diploma Received/Course of Study

List special licenses, skills, and certifications that would assist you in performing the duties of the job for which you have applied

Membership in professional or civic organization

(You may exclude those that disclose your race, color, religion, sex, national origin, ancestry, age, mental of physical handicap, citizenship status, marital status, or membership in any other protected class.)

Miscellaneous

Have you ever been convicted of a crime?

Yes

No

Have you been arrested for any reason that has not yet been resolved?

Yes

No

To help us evaluate your application, please describe the nature of the crime and your subsequent rehabilitation.

(A conviction will not necessarily disqualify an application.

Employment History

Previous Employer 1

Company Name

Phone

Address

City

State/Province

Zip/Postal

Name of Manager

Please indicate your Job Title and Describe Your Work

Month/Year that your employment started

Month/Year that your employment ended

Reason for Leaving

Compensation when your started employment

Compensation when you ended emplyment

Previous Employer 2

Company Name

Phone

Address

City

State/Province

Zip/Postal

Name of Manager

Please indicate your Job Title and Describe Your Work

Month/Year that your employment started

Month/Year that your employment ended

Reason for Leaving

Compensation when your started employment

Compensation when you ended emplyment

Previous Employer 3

Company Name

Phone

Address

City

State/Province

Zip/Postal

Name of Manager

Please indicate your Job Title and Describe Your Work

Month/Year that your employment started

Month/Year that your employment ended

Reason for Leaving

Compensation when your started employment

Compensation when you ended emplyment

List any other job related experiences, special training, skills, apprenticeships, internships, etc.

Applicant Statement and Authorization

(Read carefully prior to signing)

I certify that all answers given by me are true, accurate and complete. I understand that the falsification, misrepresentation or omission of facts on this application (or any other accompanying or required documents) will be cause for denial of employment or immediate termination of employment, regardless of when or how discovered.

I understand that as part of the selection process, the Company may conduct a routine investigation concerning my employment background, criminal record and education and that continued employment is contingent upon satisfactory results. I also understand that the Company may require the successful completion of a urinalysis for drug testing purposes and/or a blood alcohol test as a condition of employment. By submitting this Application for Employment, I hereby consent to either or both of said test, at the discretion of the Company.

I authorize the investigation of all statements and information contained in this application. I release from all liability anyone supplying such information and I also release the employer from all liability that might result from making an investigation. It is unlawful to require or administer to applicants for employment or prospective employment, or to any employee, a polygraph, lie detector, or similar test as a condition of employment or continued employment. Violation is punishable by criminal and civil penalties.

I understand that should an employment offer be extended to me and accepted, that I will be an at-will employee and that my employment and compensation may be terminated with or without cause, and with or without notice, at any time, at the option of either the Company or me. I understand that I must adhere to the policies, rules and regulations of employment of the Company. I further understand that no representation, whether oral or written by any representative or agent of the Company can constitute a contract of employment. I understand that the Company shall have the maximum discretion permitted by law to administer, interpret, modify, discontinue, enhance or otherwise change all policies, benefits, procedures or other terms or conditions of employment.

I acknowledge that I have read and understand the above statements.

Signature *

Clear