EMPLOYMENT APPLICATION
Personal Information:
Last Name:
First Name:
Middle Name:
Address:
Apt #:
City:
State:
Zip:
Home Phone
Cell Phone:
Email:
Where did you learn about RCC?
MN Workforce
Advertisement
Referral Employee
Phone Directory
Newspaper
Referral Other
Other:
Background Check:
Prior to being selected for interview, all applicants are submitted for a background check. By aggreeing below and supplying your birth date you are authorizing RCCI to run your confidential background check, which will expedite your application.
Birth Date (DD/MM/YYYY):
Maiden Name (if any):
Availability:
When are you available to start your new position?
Day:
Date:
Time:
Most of our positions start early afternoon and run until mid evening. Please check the days that you can work regularly:
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Education:
Name of School/College
Location/City/State/Zip
Area of Study
From/To (Years):
Graduated/Degrees/Diplomas
What are the main reasons for your interest in this position?
Employment History
From M/Y
To M/Y
Company & Locaiton
Position & Duties
Salary
Reason for Leaving
May we contact
this employer
for reference?
1.
Yes
No
2.
Yes
No
3.
Yes
No
References
Name
Email/Phone
Mailing Address
Relationship
Years known
1.
2.
3.
DISCLOSURE AUTHORIZATION:
“I CERTIFY THAT THE FACTS CONTAINED IN THIS APPLICATION ARE TRUE AND COMPLETE TO THE BEST OF MY KNOWLEDGE. I UNDERSTAND THAT IF EMPLOYED BY RUG & CARPET CARETAKERS, INC, FALSIFIED STATEMENTS ON THIS APPLICATION SHALL BE GROUNDS FOR DISMISSAL. I AUTHORIZE INVESTIGATION OF ALL STATEMENTS CONTAINED HEREIN. I UNDERSTAND THAT THIS APPLICATION DOES NOT ALLOW RUG AND CARPET CARETAKERS, INC. ACCESS TO ANY OF MY PERSONAL DATA, SUCH AS MEDICAL RECORDS, COMMONLY PROTECTED BY MY LEGAL CONFIDENTIALITY RIGHTS.”
IF YOU AGREE PLEASE CHECK " I AGREE" AND ENTER THE DATE:
I Agree
* Date:
*
