Employment Application

Please complete the form below. Fields marked * are required. Your information will be kept confidential.

Personal Information

Full Name*

Email*

Phone Number*

Date of Birth

Street Address

City / State / ZIP

Employment Information

Position Applying For

Available Start Date

Desired Pay (per hour)

Employment Type

Availability

Do you have a High School Diploma or GED?

Are you willing to take a drug test?

Work Experience

Employer

Position / Duties

Start Date

End Date

Reason for Leaving

Supervisor Name / Phone

References

Reference 1 (Name / Phone / Relationship)

Reference 2 (Name / Phone / Relationship)

Additional Information

Have you ever been convicted of a felony?

If yes, please explain

Additional Comments

Optional Uploads

Upload Résumé (PDF/DOC/DOCX – up to 10 MB)

Upload ID Photo (JPG/PNG – up to 5 MB)

Certification

By submitting this form, I certify that the information provided is true and complete to the best of my knowledge. I authorize verification of any information provided.

Signature (Type Full Name)*

Date*

The Continental Cleaning Company of Kansas City, LLC

Employment Application

Kansas City Metro Area

Email

Business Phone