Employment Application

Full Name: *

Street Address: *

City *

State *

Zip Code *

Telephone Number: *

Are you legally authorized to work in the United States? YesNo

Have you been convicted of a felony? YesNo

If yes, what? *

Are you 18 years old or older? YesNo

If not, please give your date of birth: *

What position are you applying for? *

If you are hired, when can you start work? *

What days and times can you work? *

Can you speak English fluently? *

Can you speak Spanish fluently? *

Have you worked in a laundry before? * YesNo

Dates: *

EDUCATION

High School

Name of School:

Location:

Number of years attended:

Did you graduate? YesNo

Date of graduation:

College

Name of School:

Location:

Number of years attended:

Did you graduate? YesNo

Date of graduation

What degree did you earn?

EMPLOYMENT HISTORY

Beginning with your most recent employment and working back in time, please give the following information:

Employer 1

Employer:

Address:

Telephone Number required:

Job Title:

Duties:

Starting Date of Employment:

Ending Date of Employment:

Starting Rate / Salary:

Ending Rate/Salary :

Supervisor:

Reason for Leaving:

Employer 2

Employer:

Address:

Telephone Number required:

Job Title:

Duties:

Starting Date of Employment:

Ending Date of Employment:

Starting Rate / Salary:

Ending Rate/Salary :

Supervisor:

Reason for Leaving:

Employer 3

Employer:

Address:

Telephone Number required:

Job Title:

Duties:

Starting Date of Employment:

Ending Date of Employment:

Starting Rate / Salary:

Ending Rate/Salary :

Supervisor:

Reason for Leaving:

PERSONAL REFERENCES

Please provide the names of two references who have not employed you and are not related to you.

Reference 1

Name:

Address:

Telephone Number:

Relationship:

Reference 2

Name:

Address:

Telephone Number:

Relationship:

ADDITIONAL QUALIFICATIONS

Please tell us about any other training, education, skills or achievements that you feel should be considered.

CUSTOMER SERVICE

Customer service is our top priority. Have you had any customer service experience where you worked one-on-one with customers? Please explain:

My answers are true and complete. I understand that if I am hired, any false or incomplete statements in this application will be grounds for immediate discharge.

Date:

Applicant's Signature: