Employment Application

Privacy Policy

We are an equal opportunity employer.

Applications are received and employees are hired without regard to race, creed, color, sex, religion, age, national origin, marital status, physical or mental handicap, disability, sexual orientation, veteran's status, citizenship status, or any other protected classes under state, local, or county regulations. The receipt of this application does not mean that job openings exist and does not obligate us in any way. We appreciate your interest in our business.

All questions must be answered. Please state "n/a" if question is not applicable.

This is a drug free workplace.


Full Name:

Email Address:

Mailing Address:



Telephone Number:


Personal Information:

Date of Application:

Position(s) Applied For:

Salary Expectation:

On what date would you be available for work?

When are you available to work? (Check all that apply.)
 Full-time Part-time Weekend Temporary

What times are you available for work? (Check all that apply.)
Sunday: a.m. p.m.
Monday: a.m. p.m.
Tuesday: a.m. p.m.
Wednesday: a.m. p.m.
Thursday: a.m. p.m.
Friday: a.m. p.m.
Saturday: a.m. p.m.

How did you hear about us?

Have you filed an application here before?
 Yes No
If yes, please provide date & location.

Have you ever been employed here before?
 Yes No
If yes, please provide date and location.

Are you employed now?
 Yes No

May we contact your present employer?
 Yes No

Does your present employer know of your plans to change employment?
 Yes No

Why do you desire to make a change?

Are you on a layoff and subject to a recall?
 Yes No

Have you ever been discharged or requested to resign from a position?
 Yes No
If yes, date and location.

How much time have you lost from work in the last 12 months?

Do you have steady transportation to work?
 Yes No

Can you travel if a job requires it?
 Yes No

Have you ever held a position of trust (handling money or confidential material)?
 Yes No

Have you ever been refused bond?
 Yes No
If yes, date & location.

Are you legally eligible to work in the United States?
(Proof of citizenship/immigration status & identity is required upon employment.)
 Yes No

Have you ever been convicted of or received a sentence for a crime(s) other than a minor traffic violation?
(Answering "yes" is not an automatic bar to employment.)
 Yes No
If so, state date, court and place where offense(s) occurred.

Do you hold a valid driver's license?
 Yes No
If yes, list state.

Have you been convicted of any moving violation(s) in the last three years?
 Yes No
If yes, give date(s) and explanation:

List three things that are important to you in a work environment:




List three characteristics that best describe you:




Why do you want to work here?


Full Employment History:

Start with your present or last job. Include all assignments and positions held. Be specific about information and dates.

A complete work history must be provided. All employment gaps should be included and explained.

Employer:

Dates Employed:

Address:

City:

State:

Zip Code:

Job Title:

Supervisor or Manager Name:

Hourly Rate/Salary:

Starting Pay/Final Pay:

Did you resign or were you terminated?

State Reason:

Summary of work performed and job responsibilities:


Employer:

Dates Employed:

Address:

City:

State:

Zip Code:

Job Title:

Supervisor or Manager Name:

Hourly Rate/Salary:

Starting Pay/Final Pay:

Did you resign or were you terminated?

State Reason:

Summary of work performed and job responsibilities:


Employer:

Dates Employed:

Address:

City:

State:

Zip Code:

Job Title:

Supervisor or Manager Name:

Hourly Rate/Salary:

Starting Pay/Final Pay:

Did you resign or were you terminated?

State Reason:

Summary of work performed and job responsibilities:


Employer:

Dates Employed:

Address:

City:

State:

Zip Code:

Job Title:

Supervisor or Manager Name:

Hourly Rate/Salary:

Starting Pay/Final Pay:

Did you resign or were you terminated?

State Reason:

Summary of work performed and job responsibilities:


Education Information

Grammar or High School

Name of School:

Years Attended:

Location:

Did you graduate?

Trade, Business or Correspondence School

Name of School:

Years Attended:

Degree Received & Major Subject:

Location:

Did you graduate?

College or Undergraduate School

Name of School:

Years Attended:

Degree Received & Major Subject:

Location:

Did you graduate?

Graduate School

Name of School:

Years Attended:

Degree Received & Major Subject:

Location:

Did you graduate?

Military Service

Branch of Service:

Present Selective Service Classification:

Rank at Discharge:

List Duties/Special Training:

Additional Comments Related to Your Application:


Agreement

The facts set forth above in my application for employment are true and complete. I understand that false statements or omission of information in this application or any other employment form may lead to dismissal or denial of employment.

I agree to provide my social security number directly to Pest Management Inc. upon request, after which time you are authorized to make any investigation of my personal history, financial, criminal, credit and motor vehicle records through any investigative or credit agencies or bureaus of your choice. You are also authorized to administer personality profile tests and verify my background. A criminal record or sentence is not an automatic disqualification for employment. I agree to submit to any drug or alcohol testing prior to or after employment and I agree to submit to a medical evaluation, if required.

On making this application for employment, I also understand that an investigative consumer report may be made whereby information is obtained through personal interviews with my neighbors, friends or others with whom I am acquainted. This inquiry includes information as to my character, general reputation, personal characteristics and mode of living. I understand that I have the right to make a written request within a reasonable period of time to receive additional, detailed information about the nature and scope of this investigative consumer report. In exchange for the consideration of my employment application by this company, I hereby release and forever discharge the company (including as directors, officers, employees and agents) and my past and/or present employers (their directors, officers, employees and agents) from any abilities which may result from an investigation of my past and/or present employment or from the disclosure of such information. I authorize the use of any information in this application to verify my statements, and I authorize the past employers, doctors, all references and any other persons to answer all questions asked concerning my ability, character, reputation and previous employment record.

I understand that if my application is accepted that employment with this company at all times is employment "at will." It is further understood That this "at will" relationship may not be changed by any written document, verbal statements, or by conduct unless such change is speCifically acknowledged by an authorized executive of the company. I further understand that my "at will" employment may be terminated at any time by myself or the company and includes no guarantee, contract or promise of employment for any specific length of time. I understand that the first ninety (90) days of employment is a new hire introductory period.