Employment - Quality Maintenance Enterprises

Name*
First Middle Last
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Main Phone*
Alt Phone
Date Available*
Date Format: MM slash DD slash YYYY
Minimum Wage*
Please enter a number greater than or equal to 8.05.
Position Applied for*
Hours available for work*
Monday Tuesday Wednesday Thursday Friday Saturday Sunday
Are you a citizen of the United States?
- Yes
- No
Are you authorized to work in the U.S.?*
- Yes
- No
Have you ever worked for this company?*
- Yes
- No
When did you work here?*
Have you ever been convicted of a felony or theft related crime?*
- Yes
- No
Please explain*

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List at least 3 references*
Full Name Relationship Company Phone # Address

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Employment History*
Company Phone Address Job title Supervisor Responsibilities From To Reason for Leaving May we contact your previous supervisor for a reference?

Give at least 5 years of previous employment history, please include any self employment
Did you attend the military?*
- Yes
- No
Military Service
Branch*
From*
Date Format: MM slash DD slash YYYY
To*
Date Format: MM slash DD slash YYYY
Rank at Discharge*
Type of Discharge*
Explain*

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It is the policy of Quality Maintenance Ent., to provide employment opportunities to all qualified persons without regard to race, age, color, sex, religion, disability, or marital status.

prospective Employee Release of Information Form For Employment

In connection with my application for employment with Quality Maintenance Enterprises, I hereby agree as follows:
1. GENERAL CONSENT TO BACKGROUND INVESTIGATION
  
  As a condition of consideration of my employment application, I give permission to Quality Maintenance Enterprises to investigate my personal and employment history. I understand that this background investigation will include, but not be limited to, verification of all information on my employment application.
2. CONSENT TO CONTACT PAST EMPLOYERS
  
  I specifically give permission to Quality Maintenance Enterprises to contact all of my prior employers for references. I further give permission to all current or previous employers and/or managers or supervisors to discuss my relevant personal and employment history with Quality Maintenance Enterprises, consent to the release of such information orally or in writing, and hereby release them from all liability and agree not to sue them for defamation or other claims based upon any statements that make to any representative of Quality Maintenance Enterprises. I further waive all rights I may have under law to receive a copy of any written statement provided by any of my former employers for any liability they may incur because of their reliance upon this Agreement.
Signature
By signing below, I certify that my answers are true and complete to the best of my knowledge.
If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.
Signature*
Name*
Print complete name
Prefix First Middle Last Suffix
Date*
Phone
This field is for validation purposes and should be left unchanged.

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Employment Application

Step 1 of 5 - Applicant Information

Military Service

prospective Employee Release of Information Form For Employment

GENERAL CONSENT TO BACKGROUND INVESTIGATION

CONSENT TO CONTACT PAST EMPLOYERS

Signature

Degree (Bachelors, Associates, etc.)	Field of Study

Full Name	Relationship	Company	Phone #	Address

Company	Phone	Address	Job title	Supervisor	Responsibilities	From	To	Reason for Leaving	May we contact your previous supervisor for a reference?