Phone Number (required)
Cell Number (required)
Date of Birth (required)
Driver License Number (required)
Are you 18 years of age or older? (required)
How did you hear about us? (required)
Are you currently able to be employed lawfully in this country? (required)
G.C.S. will obtain documentation supporting proof of citizenship or immigration status.
Position Applied for: (required)
---1st Shift2nd Shift3rd Shift
Available date to start? (required)
Can you work overtime as needed? (required)
If Yes, Current Employer Name:
If No, Please explain:
Are you currently laid off? (required)
If Yes, Explain.
Elementary Years Attended:
High School Name:
High School Years Attended:
High School Graduated:
College/Trade Years Attended:
Reason for Leaving:
Dates of Employment
EMPLOYMENT QUALIFICATION QUESTIONNAIRE
How many days were you absent during the past year?
0-5 days6-10 days10+ days
Which previous employer did you like best and why?
We are a company with a zero tolerance for harassment and discrimination. Have you ever been accused of sexual or other harassment or employment discrimination?
If Yes, Please Explain:
Have you ever been arrested for or convicted of a crime that has not been expunged by a court? A conviction does not bar you from employment. Type of conviction, when convicted are considered.
Reference #1 - Name:
Reference #2 - Name:
Reference #3 - Name:
I hereby authorize the release of employment data pertaining to my employment with Glenn’s Cleaning Service LLC. I acknowledge and authorize a criminal background check and agree to submit to any lawful drug, alcohol, or other testing that may be required in obtaining and the continuation of employment. I fully understand that if employed, any misrepresentation or omission on this application can result in dismissal of employment at any time. This application or the hiring process is not considered an employment contract of any kind. I understand Glenn’s Cleaning Service may alter Employee Policies, Practices, and/or other Company Policies.