- www.GoBestClean.Com

Job Application

We request the following information to help us make the best possible placement. To be
considered for a position, this application must be fully completed.
If offered employment and accepted, you are required by law to show proof of eligibility to
work in the USA and are 18 years of age or over.

First Name

Last Name

Gender:

Male

Female

A background check and Drug tests will be conducted:

Background checks?

Excellent

Not Good

Drug tests?

Excellent

Not Good

Address Line 1

Address Line 2

City

State

Zip Code

Country

Cell Phone:

Are you a Citizen of the United States?

Yes

Are you not a Citizen of the United States? USCIS

Select Position Applied Type:

How did you learn about Best Clean and this position?

Have you ever been employed with us before?

Yes

Employment Preference:

Full Time

Part Time

Shift Preference:

Daytime

Evening

Earliest Available Start Date:

Education Background

What languages do you speak?

English

Spanish

Other

If the job required it, do you have a valid driver’s license or State Photo valid ID card?

Yes

State ID card or Driver's License, Number:

Expiration Date:

Employment History

Please complete all information below, listing the most recent or current employer first.

Are you currently employed?

Yes

Wage:

1) Position Job title/duties:

Company Name:

City:

State:

Cell Phone:

Have you been employed before or prior to your current job?

Yes

Wage:

(2)Position Job title/duties:

Company Name:

City:

State:

Cell Phone:

Personal Reference and Emergency Contact:

1) First Name

1) Last Name

Relationship:

Cell Phone:

2) First Name

2) Last Name

Relationship:

Cell Phone:

PLEASE READ THE FOLLOWING STATEMENT CAREFULLY:

In consideration of my employment, I agree to conform to the policies and procedures of the company. I
understand that in accepting this application, the company is in no way obligated to provide me with
employment and that I am not obligated to accept employment if offered. Furthermore, if employed, I
understand that I am employed at will and that my employment and compensation can be terminated with or
without cause, and with or without notice at any time.

I certify that the facts contained in this application are true and complete to the best of my knowledge. I
understand that any falsified statements on this application or omission of fact on either this application or
during the pre-employment process will result in my application being rejected, or, if I am hired, in my
employment being terminated. I also understand that any offer of employment is contingent upon the
completion of pre-employment tests and documentation. I will, upon request, sign all necessary consent forms.

I Understand and Agree with the Above Statement.

Yes

Employment Print Name:

Today’s Date:

We request the following information to help us make the best possible placement. To beconsidered for a position, this application must be fully completed.If offered employment and accepted, you are required by law to show proof of eligibility towork in the USA and are 18 years of age or over.

A background check and Drug tests will be conducted:

Education Background

Employment History

Personal Reference and Emergency Contact:

PLEASE READ THE FOLLOWING STATEMENT CAREFULLY:

We request the following information to help us make the best possible placement. To be
considered for a position, this application must be fully completed.
If offered employment and accepted, you are required by law to show proof of eligibility to
work in the USA and are 18 years of age or over.