Online Application


 
All candidates are put through a thorough drug and criminal background check prior to starting. * = Required Field
Applicant Information
First Name: *
  Middle Initial:  
  Last Name: *
Address: *
  Apartment #:  
City: *
  State: *
  Zip: *
* Please provide one or more of the following: Home Phone, Cell Phone or Email.
Home Phone:  
  Cell Phone:  
Email:  
  Position Applied For:  
Are you able to lift up to 50 pounds?  
  
  How did you hear about this position?  
Desired Salary:  
 
Are you a United States citizen?  
  
  If no, are you authorized to work in the US?  
  
Have you ever worked for Cleantec before?  
  
  If so, when?  
Have you ever been convicted of a crime?  
  
  If so, explain:  
* Prior to employment, a criminal history background check will be conducted. Checking yes will not necessarily exclude you from employment consideration.
Are you Available to Work:  
  
  Date Available to Begin Work:  
Days Available:  
           
Are you known under any other name:  
Are you currently employed?  
  
  If yes, may we contact your current employer to obtain employment information?  
  
Do you have a valid drivers license?  
  
  Do you have personal transportation?  
  
* You will be asked to provide Cleantec with a copy of your Insurance Card upon hire.

Education
High School
Name & Location:  
  Years Completed:  
        
Graduated:  
  
  Degree/Major:  
College/University or Other Training
Name & Location:  
  Years Completed:  
        
Graduated:  
  
  Degree/Major:  

Employment History
* This portion must include a minimum of 10 year work history and must be completed even if supplemented by a resume.
Company:  
  Phone:  
Address:  
  Supervisor:  
Job Title:  
  Reason for Leaving:  
Starting Salary:  
  Ending Salary:  
Employment Dates:  
 /    To    / 
Company:  
  Phone:  
Address:  
  Supervisor:  
Job Title:  
  Reason for Leaving:  
Starting Salary:  
  Ending Salary:  
Employment Dates:  
 /    To    / 
Company:  
  Phone:  
Address:  
  Supervisor:  
Job Title:  
  Reason for Leaving:  
Starting Salary:  
  Ending Salary:  
Employment Dates:  
 /    To    / 

References
* Please List Three Professional References – NO RELATIVES.
Full Name:  
  Relationship:  
Company:  
  Phone:  
Address:  
Full Name:  
  Relationship:  
Company:  
  Phone:  
Address:  
Full Name:  
  Relationship:  
Company:  
  Phone:  
Address:  

Military Service
* Complete this section if you served in the US. Armed Forces.
Branch of Service:  
  Period of Active Duty:  
Rank at Discharge:  
  Date of Discharge:  

Disclaimer - PLEASE READ CAREFULLY
It is our policy to comply fully with federal, state, and local employment opportunity laws. Cleantec provides equal opportunity and advancement opportunities for all persons regardless of race, creed, sex, national origin. Disability, marital status and sexual orientation or any other classification protected by law.

I hereby certify that all of the information I have provided on this Employment Application is true and correct to the best of my knowledge. I understand that any misrepresentation of facts will disqualify me from further consideration of employment, withdrawal of any offer for employment, or termination of employment, if hired.

Cleantec is committed to providing a drug and alcohol- free workplace. After receiving a conditional offer or employment, I understand that a drug test will be required before starting work. If the results for the test are positive, I understand that the offer for employment will be withdrawn.

If employed, I agree to abide by all policies, rules, and regulations of the organization. I understand and agree that, if hired my employment is for no definite period and may, regardless of the date of payment of my wages or salary, be terminated by myself or Cleantec at any time with or without cause or notice. I further understand that the policies, procedures, rules, and benefits contained in the employee handbook, benefit plans, and other written documents should not be considered an employment contract for any period of time.




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1232 Tulip Street

Liverpool, NY 13090

Phone: (315) 463-5353

Fax: (315) 463-4029


950 Danby Rd

Suite 225

Ithaca, NY 14850

Phone: (607) 589-7828

Fax: (607) 589-7841

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