In compliance with Federal and State equal employment opportunity laws, qualified applicants are considered for all positions without regard to race, color, religion, sex, national origin, age, marital status, or non-job related disability.
Position(s) Applied For*
Position Type*
- Full Time
- Part Time
- Temporary
First Name*
Middle Name*
Last Name*
Phone*
Email*
Drivers License #*
Current Address
Street*
City*
State*
Zip Code*
How Long?*
Previous Address
Street
City
State
Zip Code
How Long?
Add Another Previous Address
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Street
City
State
Zip Code
How Long?
Add Another Previous Address 2
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Street
City
State
Zip Code
How Long?
Add Another Previous Address 3
- Add Another Previous Address?
Street
City
State
Zip Code
How Long?

Reference and Background
Contact Name*
Home Phone*
Address*
Work Phone*
City*
State*
Zip*
How is this person related to you?*
Do you have the legal right to work in the United States?*
- Yes
- No
Have you worked for Power Sweep Services, LLC. before?*
- Yes
- No
Start Date of Previous Work
MM slash DD slash YYYY
End Date of Previous Work
MM slash DD slash YYYY
Rate of Pay
Position
Reason for Leaving
Are you currently employed?*
- Yes
- No
If not, how long since leaving last employment?
Who referred you?*
Rate of pay expected?*
Is there any reason you might be unable to perform the functions of the job for which you have applied?*
If yes, explain if you wish

Education and Employment History
Highest Grade Completed*
Years of College Completed*
Last School Attended*
City*
Employment History

Note: List employers in reverse order starting with the most recent.
Employer Name*
City*
State*
Zip*
Start Date*
MM slash DD slash YYYY
End Date*
MM slash DD slash YYYY
Position Held*
Salary / Wage*
Contact Person*
Phone Number*
Reason for Leaving*
Add Another Employer
- Add Another Employer?
Employer Name*
City*
State*
Zip*
Start Date*
MM slash DD slash YYYY
End Date*
MM slash DD slash YYYY
Position Held*
Salary / Wage*
Contact Person*
Phone Number*
Reason for Leaving*

Experiences and Qualifications - Other
Provide any experience that may help in your work for this company:*
List special equipment or technical materials you can work with (other than those already shown):*

To Be Read by Applicant

This certifies that this application was completed by me, and that all entries on it and information in it are true and complete to the best of my knowledge. I authorize you to make such investigations and inquiries of my personal, employment, financial, or medical history and other related matters as may be necessary in arriving at an employment decision. (Generally, inquiries regarding medical history will be made only if and after a conditional offer of employment has been extended.) I hereby release employers, schools, health care providers and other persons from all liability in responding to inquiries and releasing information in connection with my application. In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand, also, that I am required to abide by all safety rules and regulations of the Company.
Agreement
- I agree

Sweeping Truck, Line Striping,and Power Washing Employment Opportunities

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