Application Form Personal Information Full Name(Required) First Email Address(Required) Phone(Required)Birth Date MM slash DD slash YYYY Address Street Address City Enter StateAlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State Postal Code Emergency Contact Information Emergency Contact Full Name First Emergency Contact Phone NumberEmergency Contact Email Address Position Information Do you have reliable transportation to work? Yes No Are you willing to work weekends and holidays? Yes No Have you ever worked for Clean Wave Car Wash before? Yes No Are you looking for a summer job or year-round? Summer Year-Round If you know any employees that currently work here, please list them: Availability Times available to work each day: Unavailable Mondays Unavailable Mondays Mondays available from (Start Time) Hours : Minutes to (End Time) Hours : Minutes Unavailable Tuesdays Unavailable Tuesdays Tuesdays available from (Start Time) Hours : Minutes to (End Time) Hours : Minutes Unavailable Wednesdays Unavailable Wednesdays Wednesdays available from (Start Time) Hours : Minutes to (End Time) Hours : Minutes Unavailable Thursdays Unavailable Thursdays Thursdays available from (Start Time) Hours : Minutes to (End Time) Hours : Minutes Unavailable Fridays Unavailable Fridays Fridays available from (Start Time) Hours : Minutes to (End Time) Hours : Minutes Unavailable Saturdays Unavailable Saturdays Saturdays available from (Start Time) Hours : Minutes to (End Time) Hours : Minutes Unavailable Sundays Unavailable Sundays Sundays available from (Start Time) Hours : Minutes to (End Time) Hours : Minutes Any sports or activities that we would need to schedule around? Referral Source Referral SourceAdvertisementFriendNow Hiring SignOtherIf Other, please explain Personal References List two personal references not related to you and not employed by Clean Wave Car Wash. Reference 1 Full Name First RelationshipEmail Address Phone Number Reference 2 Full Name First RelationshipEmail Address Phone Number Education Highest grade completedName of the last school attended Employment History Employment #1 Most recent or current employer Employer Company NameSupervisorEmployer AddressEmployer CityEmployer PhoneStarting Salary / Hourly WagePresent or Last Salary / Hourly WageStart Date MM slash DD slash YYYY End Date MM slash DD slash YYYY Type of Work PerformedReason for Leaving Employment #2 Most recent or current employer Employer Company NameSupervisorEmployer AddressEmployer CityEmployer PhoneStarting Salary / Hourly WagePresent or Last Salary / Hourly WageStart Date MM slash DD slash YYYY End Date MM slash DD slash YYYY Type of Work PerformedReason for Leaving Military Experience Armed Forces Type Army Navy Marines Air Force Coast Guard National Guard Dates of Service From MM slash DD slash YYYY To MM slash DD slash YYYY Military RankKey Skills Acquired Additional Information Languages Spoken (other than English)Are you legally authorized to work in the United States? Yes No Do you have a current valid driver's license? Yes No Background Information Have you ever pled "guilty" or "no contest" to a crime or been convicted of a crime? Yes No If yes, please provide the date and detailsHave you ever been convicted of a DUI or DWI? Yes No If Yes, please specify the date Employment Application Agreement I certify that the answers given by me to the foregoing questions and statements are true and correct to the best of my knowledge without consequential omissions of any kind. I agree that the Company shall not be held liable if my employment is rejected or terminated due to false statements, answers, or omissions. I understand that misleading or incorrect statements may render this application void and may lead to termination if employed. I acknowledge that employment with Clean Wave Car Wash is at-will and may be terminated at any time by either party. I agree to the terms of this employment application Yes No EmailThis field is for validation purposes and should be left unchanged.
