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Employment Application
NOTICE: Building Maintenance Technologies, Inc., including all of its divisions, is an equal opportunity employer. No question on this application is intended for or will be used to exclude any person, regardless of race, color, sex, religion, age, national origin, sexual orientation or any other basis not related to the needs of the company. We will not knowingly hire a non-employable alien. We follow and obey the provisions of Title VII of the Civil Rights Act of 1964, the Age Discrimination Act of 1967, the Americans with Disabilities Act, and the Immigration Reform and Control Act of 1986.
IF YOU FEEL ANSWERING A QUESTION CONTAINED IN THIS APPLICATION WOULD VIOLATE YOUR CIVIL RIGHTS, PLEASE OMIT THE ANSWER TO THAT QUESTION.
Personal Information
Last Name
First Name
Middle Name
Address
Apt #
City
State
Zip
-- Select a State --
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Colombia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
-- Canadian Province--
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Nova Scotia
Northwest Territories
Nunavut
Ontario
Prince Edward Island
Québec
Saskatchewan
Yukon
-- Australian Province--
Ashmore and Cartier Islands
Australian Antarctic Territory
Australian Capital Territory
Christmas Island
Cocos (Keeling) Islands
Coral Sea Islands
Heard Island and McDonald Islands
Jervis Bay Territory
New South Wales
Norfolk Island
Northern Territory
Queensland
South Australia
Tasmania
Victoria
Western Australia
Armed Forces Europe
Armed Forces Pacific
American Samoa
Federated States of Micronesia
Guam
Marshall Islands
Palau
Puerto Rico
Virgin Islands
DLN (if position requires driving)
State
Endorsements
-- Select a State --
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Colombia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
-- Canadian Province--
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Nova Scotia
Northwest Territories
Nunavut
Ontario
Prince Edward Island
Québec
Saskatchewan
Yukon
-- Australian Province--
Ashmore and Cartier Islands
Australian Antarctic Territory
Australian Capital Territory
Christmas Island
Cocos (Keeling) Islands
Coral Sea Islands
Heard Island and McDonald Islands
Jervis Bay Territory
New South Wales
Norfolk Island
Northern Territory
Queensland
South Australia
Tasmania
Victoria
Western Australia
Armed Forces Europe
Armed Forces Pacific
American Samoa
Federated States of Micronesia
Guam
Marshall Islands
Palau
Puerto Rico
Virgin Islands
How do you plan to get to work?
Date
SSN (Optional)
Phone
Pager
Cell
Employment Interests
Position Desired
Date Available to Start
Minimum Desired Wage per Hour
Select an Option
House Cleaner
Supervisor
Manager
Salesperson
Floor Tech
Janitor
Where did you hear of job?
Have you applied here before?
Have you been employed here before?
Select an Option
Previous Customer
Yellow Page Ad
Magazine Ad
Newspaper Ad
Television Ad
Radio Ad
Yahoo Search
Google Search
Friend
Family
Other
Select an Option
No
Yes
Select an Option
No
Yes
Were you ever bonded?
Will you work overtime?
Are you 18 or older?
Select an Option
No
Yes
Don't know
Select an Option
No
Yes
Select an Option
No
Yes
Do you enjoy cleaning?
Do you consider yourself to be organized?
Hours per week would you like to work?
Select an Option
Yes
No
Select an Option
Yes
No
Select an Option
10-15 Hours
15-20 Hours
20-25 Hours
25-30 Hours
30+ Hours
Would you be willing to start part-time?
Do you consider yourself to be friendly and outgoing?
Select an Option
Yes
No
Select an Option
Yes
No
Are you applying for:
Are you legally eligible for employment in the United States?
Full Time
Part Time
Seasonal
Select an Option
No
Yes
Have you been convicted of a violent or theft related crime?
Select an Option
No
Yes
Please Explain:
Conviction will not necessarily be a bar to employment. Each instance and explanation will be considered in relation to the position for which you are applying.
Employment History
Starting with most recent, list your former employers, assignments, or volunteer activities filling in the details as specified. Use an additional sheet of paper if necessary. Explain any gaps in employment in the space provided below. Incomplete disclosure of facts called for may void your application.
Employer
Phone
Address
Job Title
Immediate Supervisor and Title
Reason for leaving
Employed From
Employed To
Starting wage (Hourly rate/salary)
Hourly
Yearly
Final wage (Hourly rate/salary)
Hourly
Yearly
Summarize the type of work and your duties
Employer
Phone
Address
Job Title
Immediate Supervisor and Title
Reason for leaving
Employed From
Employed To
Starting wage (Hourly rate/salary)
Hourly
Yearly
Final wage (Hourly rate/salary)
Hourly
Yearly
Summarize the type of work and your duties
Employer
Phone
Address
Job Title
Immediate Supervisor and Title
Reason for leaving
Employed From
Employed To
Starting wage (Hourly rate/salary)
Hourly
Yearly
Final wage (Hourly rate/salary)
Hourly
Yearly
Summarize the type of work and your duties
Opinion
Please enter the following questions about yourself and your previous jobs.
Do you use illegal drugs? Have you used illegal drugs in the past 2 years?
What is your greatest weakness? What is your greatest strength?
Can you perform the functions of this job (essential and/or marginal) with or without reasonable accomodation?
Can you meet the attendance requirements of this job? How many days of leave did you take last year?
What would your current or previous employer tell us about you?
Availability
Indicate in the table below what days you are able to work and specify 1st, 2nd, and/or 3rd shift. Shifts are usually no longer than 8 hours. The start time and the end time of the 1st, 2nd or 3rd shift usually falls between the time indicated in the table below.
Shift time
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
6am - 4pm
1st
1st
1st
1st
1st
1st
1st
3pm - 11pm
2nd
2nd
2nd
2nd
2nd
2nd
2nd
10pm - 7am
3rd
3rd
3rd
3rd
3rd
3rd
3rd
Emergency Information
In case of emergency notify:
Relationship
Phone
Address
City
State
Zip
-- Select a State --
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Colombia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
-- Canadian Province--
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Nova Scotia
Northwest Territories
Nunavut
Ontario
Prince Edward Island
Québec
Saskatchewan
Yukon
-- Australian Province--
Ashmore and Cartier Islands
Australian Antarctic Territory
Australian Capital Territory
Christmas Island
Cocos (Keeling) Islands
Coral Sea Islands
Heard Island and McDonald Islands
Jervis Bay Territory
New South Wales
Norfolk Island
Northern Territory
Queensland
South Australia
Tasmania
Victoria
Western Australia
Armed Forces Europe
Armed Forces Pacific
American Samoa
Federated States of Micronesia
Guam
Marshall Islands
Palau
Puerto Rico
Virgin Islands
Electronic Signature and Agreement
I understand that if I am employed, any misrepresentation or material omission made by me on this application will be sufficient cause for cancellation of this application or discharge from Building Maintenance Technologies, Incorporated's (including all its divisions) service, whenever it is discovered. I give Building Maintenance Technologies, Inc. and all its divisions the right to contact and obtain information from all references, employers, educational institutions and to otherwise verify the accuracy of the information contained in this application. I hereby release from liability Building Maintenance Technologies, Inc. and all its divisions along with its representatives for seeking, gathering, and using such information and all other persons, corporations or organizations for furnishing such information. Building Maintenance Technologies, Inc. does not unlawfully discriminate in employment and no question on this application is used for the purpose of limiting or excusing any applicant from consideration for employment on a basis protected by federal, state, or local law. This application is current for 60 days. At the conclusion of this time, if I have not heard from Building Maintenance Technologies, Inc or its divisions and still wish to be considered for employment, it will be necessary to fill out a new application. If I am hired, I understand that I am free to resign at anytime with or without cause and without prior notice, and Building Maintenance Technologies, Inc and its divisions reserves the same right to terminate my employment at anytime with or without cause and without prior notice, except as may be required by law. This application does not constitute an agreement or contract for employment at any time or definite duration. I understand it is this company's policy not to refuse to hire a qualified individual with a disability because of that person's need for a reasonable accommodation as required by the ADA. I also understand that if I am hired, I will be required to provide proof of identity and legal work authorization as required by IRCA.
Electronic Signature
Date Submitted
* Required Fields
260.484.7413
Excellence without Exception
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