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Application for Employment

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Application for Employment

We are committed to a policy of equal employment opportunity and will not discriminate on any legally recognized basis including, but not limited to, race, age, color, religion, sex, marital status, national origin, citizenship, ancestry, physical or mental disability, veteran status, or any other legally protected basis

Name
First Last
Phone
Email*
Address
Street Address Address Line 2 City State ZIP Code
Social Security #
Driver's License #
State
State
Driving is a requirement. Is this a valid driver’s license?
- Yes
- No
Do you have full time access to a vehicle?
- Yes
- No
Is your vehicle in good and safe mechanical condition?
- Yes
- No
Has your driver’s license been suspended?
- Yes
- No
Have you ever been convicted of a criminal offense?
- Yes
- No
Note: due to the security-sensitive nature of the job, all employees are required to be bonded. As a matter of policy, the company conducts a police background and driving check on any applicant in consideration for hiring.
Are you able to lift 50 lbs. or more?
- Yes
- No
Would you have difficulty standing, bending, or kneeling in connection with performing necessary cleaning duties.
- Yes
- No
What days of the week are you able to work?
- Monday
- Tuesday
- Wednesday
- Thursday
- Friday
- Saturday
- Sunday
What hours on these days are you able to work?
If you are hired when can you start work?
MM slash DD slash YYYY
Are you presently employed?
- Yes
- No
If yes, may we contact your employer?
- Yes
- No
Which of the of the following categories of jobs have you had?
- Housecleaning
- Fast Food
- Homemaker
- Hotel / Motel
- Janitorial
- Manufacturing
- Restaurant
- Sales
- Service
- Other
Other (please explain)
Work Experience
List below last three employers, starting with your present or last place of employment. You may include in such history any verified work performed on a volunteer basis.
Employer's Name
Position
Salary
From
MM slash DD slash YYYY
To
MM slash DD slash YYYY
Reason for Leaving
Supervisor Name
Employer's Phone #
Employer's Name
Position
Salary
From
MM slash DD slash YYYY
To
MM slash DD slash YYYY
Reason for Leaving
Supervisor Name
Employer's Phone #
Employer's Name
Position
Salary
From
MM slash DD slash YYYY
To
MM slash DD slash YYYY
Reason for Leaving
Supervisor Name
Employer's Phone #
Education
High School
Graduated
- Yes
- No
Major Area of Study
College
Graduated
- Yes
- No
Major Area of Study
Trade, Business or Graduate School
Graduated
- Yes
- No
Major Area of Study
Personal References
List below last three employers, starting with your present or last place of employment. You may include in such history any verified work performed on a volunteer basis.
1. Name
First Last
Years Known
Occupation
Phone
Address
Street Address City State ZIP Code
2. Name
First Last
Years Known
Occupation
Phone
Address
Street Address City State ZIP Code
3. Name
First Last
Years Known
Occupation
Address
Street Address City State ZIP Code
Phone
To what extent would the following job characteristics be attractive to you?
More flexible daytime hours than other jobs
- Very Great
- Great
- Somewhat
- Little
- Very Little
Working in a team environment
- Very Great
- Great
- Somewhat
- Little
- Very Little
The opportunity to become a team manager
- Very Great
- Great
- Somewhat
- Little
- Very Little
Physical activity and exercise
- Very Great
- Great
- Somewhat
- Little
- Very Little
The opportunity full-time part-time
- Very Great
- Great
- Somewhat
- Little
- Very Little
Helping clients by keeping their homes clean
- Very Great
- Great
- Somewhat
- Little
- Very Little
A good relationship with fellow employees
- Very Great
- Great
- Somewhat
- Little
- Very Little
Recognition from management for good work
- Very Great
- Great
- Somewhat
- Little
- Very Little
The opportunity to earn bonuses and awards
- Very Great
- Great
- Somewhat
- Little
- Very Little
Applicant's Statement
I certify that all the foregoing information is a complete and accurate statement of the facts and understand that if any misrepresentation, omission or falsification be discovered, it will constitute grounds for dismissal. I hereby authorize the company to which I am applying to conduct any investigation necessary concerning any part of my background related to the position I am seeking, including, but not limited to the obtaining a police report and driving record. I authorize any of the persons or organizations named in this application to provide complete information and records regarding my employment education, character, and qualifications. I release all parties from any liability in connection with the provision and use of such information.
- Yes
- No
I understand and agree that, if employed by this company, I will be responsible for familiarizing myself with all rules and regulations of the company as they presently exist or are later modified and that I will abide by its rules and regulations which are subject to change.
- Yes
- No
I also understand that no representative of the company has the any authority to enter into any employment agreement for any specified period of time, or to assure me of any future position, benefits or terms and conditions of employment. I further understand that, if hired my employment is for no definite period of time and may be terminated by either party at any time.
- Yes
- No
Comments
This field is for validation purposes and should be left unchanged.

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Halverson Building Services
1515 Michigan St NE Ste. 122
Grand Rapids, MI 49503

(616) 608-5356

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Halverson Building Services
1515 Michigan St NE Ste. 122
Grand Rapids, MI 49503

(616) 608-5356

Contact Us Online

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