Apply For Employment | A Lot A Clean

Use the form below to submit your contact information and resume. We look forward to hearing from you.

Personal Information
This application form is intended for use in evaluating your qualifications for employment. This is not an employment contract. The application must be filled out completely and accurately to be considered. False or misleading statements during the interview and on this form are grounds for terminating the application process or, if discovered after employment, terminating employment. All qualified applicants will receive consideration without discrimination because of sex, marital status, race, color, age, creed, national origin or the presence of disabilities. A felony conviction will not necessarily bar an applicant from employment. Additional testing of job-related skills and for the presence of drugs in your body may be required prior to employment. compliance with the Company Policy is a requirement for all employees.
Name*
First Last
Email*
Email
Address*
Street Address City State / Province / Region ZIP / Postal Code Country
Phone*
Phone Number
Do you have reliable transportation to work?*
Do you have reliable transportation to work?
Do you have a driver's license?*
Do you have a driver's license?
If yes, Class:
If yes, Class:
If Yes, State:
If Yes, State:
Any moving violations or accidents in the past three years?
Any moving violations or accidents in the past three years?
If yes, please provide details.
If yes, please provide details.
Have you ever been convicted of a felony?
Have you ever been convicted of a felony?
If yes, please provide details.
If yes, please provide details.
Can you provide documentation of your legal right to work in the U.S.?
Can you provide documentation of your legal right to work in the U.S.?
Can you read at a 5th grade level?
Can you read at a 5th grade level?
If there is additional information regarding name change necessary to verify employment and education records, please provide details.
If there is additional information regarding name change necessary to verify employment and education records, please provide details.
Employment Desired
Position
Position
Salary requirement per/hour
Salary requirement per/hour
Starting date
Starting date
MM slash DD slash YYYY
Are you looking for Full-time or Part-time work?
Are you looking for Full-time or Part-time work?
If Part-time, what days can you work?
If Part-time, what days can you work?
Have you ever applied to this company before?
Have you ever applied to this company before?
Previous Employers
You may upload a resume, but please list below your last three employers, starting with the last one first.
You may upload a resume here.
You may upload a resume here.
Max. file size: 512 MB.
Dates employed (Starting and end)
Dates employed (Starting and end)
Company name
Company name
Phone Number
Phone Number
Supervisor's name/position
Supervisor's name/position
Salary (Starting and Final)
Salary (Starting and Final)
Your Position
Your Position
Reason for leaving?
Reason for leaving?
Dates employed (Starting and end)
Dates employed (Starting and end)
Company name
Company name
Phone Number
Phone Number
Supervisor's name/position
Supervisor's name/position
Salary (Starting and Final)
Salary (Starting and Final)
Your Position
Your Position
Reason for leaving?
Reason for leaving?
Dates employed (Starting and end)
Dates employed (Starting and end)
Company name
Company name
Phone Number
Phone Number
Supervisor's name/position
Supervisor's name/position
Salary (Starting and Final)
Salary (Starting and Final)
Your Position
Your Position
Reason for leaving?
Reason for leaving?
Education
High School
High School
Location and Phone Number
Location and Phone Number
Years Completed
Years Completed
Major/Degree
Major/Degree
Graduate?
Graduate?
College
College
Location and Phone Number
Location and Phone Number
Years Completed
Years Completed
Major/Degree
Major/Degree
Graduate?
Graduate?
Trade, Business, or Correspondence School
Trade, Business, or Correspondence School
Location and Phone Number
Location and Phone Number
Years Completed
Years Completed
Major/Degree
Major/Degree
Graduate?
Graduate?
References
Include individuals familiar with your work ability. Do NOT include relatives.
Name
Name
Address and Phone
Address and Phone
Years known
Years known
Name
Name
Address and Phone
Address and Phone
Years known
Years known
Name
Name
Address and Phone
Address and Phone
Years known
Years known
Additional comments
By submitting this application, I certify that I have read and understood the Applicant Note on section one of this form and the answers given by me to the foregoing questions and the statements made by me are complete and true to the best of my knowledge and belief. I understand that any false information, omissions or misrepresentations of the facts called for in this application may result in the rejection of my application or discharge at any time during my employment. I authorize the company and all former employers; persons, schools, company and law enforcement authorities from all liability for any damage whatsoever that may result from the utilization or issuing of this information. I also understand that illegal drugs are prohibited during employment. If Company Policy requires, I am willing to submit to drug testing to detect the use of illegal drugs prior to and during employment.
Why would you be a good choice for this position?
Why would you be a good choice for this position?
Date
Date
MM slash DD slash YYYY
Phone
This field is for validation purposes and should be left unchanged.

Employment

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Personal Information

Employment Desired

Previous Employers

Education

References

Additional comments

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