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Blackburn Building Services Online Application
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Name
*
First
Middle
Last
Present address
*
Address Line 1
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
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Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Email
Cell phone
*
Telephone
Are you at least 18 years old?
*
Yes
No
Are you legally eligible for employment in this country?
*
Yes
No
(PROOF OF US CITIZENSHIP OR IMMIGRATION STATUS WILL BE REQUIRED UPON EMPLOYMENT)
Position applied for
*
Cleaning Technician
Supervisor (may not be available)
Other
Will you work overtime if required?
*
Yes
No
How many hours can you work weekly?
*
Can you work nights?
*
Yes
No
Employment Desired
*
FULL-TIME ONLY
PART-TIME ONLY
FULL OR PART-TIME
Education
TYPE OF SCHOOL
High School
College
Business or Trade School
Professional School
NAME OF SCHOOL
*
Location
*
Number of years completed
*
Any details you would like to add
HAVE YOU EVER BEEN CONVICTED OF A FELONY OR MISDEMEANOR?
*
Yes
No
If yes, please explain
*
DO YOU HAVE A DRIVERS LICENSE?
*
Yes
No
What is your means of transportation to work?
*
What type of drivers license do you have?
Operator (basic)
Commercial (CDL)
Date of expiration
Please list two references other than relatives or previous employers.
*
Name
Position of Reference
(copy)
Company
Address Line 1
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
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
State
2nd Reference (other than relatives or employers)
*
Name
(copy)
Position of Reference
Company
Address Line 1
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
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
State
Use the space below to summarize any additional information necessary to describe your full qualifications for the specific position for which you are applying.
Work Experience
Please list your work experience for the past five years beginning with your most recent job held. If you were self-employed, give firm name. Attach additional sheets if necessary.
Name of Employer
*
Address Line 1
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
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
State
Name of last supervisor
Employment dates from
to employment end date:
Pay or salary
Write starting pay $ and final pay
Your last job title
Reason for leaving (be specific)
*
List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company.
Name of Employer
Address Line 1
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
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
State
Name of supervisor
Employment dates from
to employment end date:
Pay or salary
Write starting pay and final pay
Your job title
Reason for leaving (be specific)
List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company.
Name of Employer
Address Line 1
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
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
State
Name of supervisor
Employment dates from
to employment end date:
Pay or salary
Write starting pay and final pay
Your job title
Reason for leaving (be specific)
List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company.
May we contact your present employer?
*
Yes
No
I don't have a current employer
Did you complete this application yourself?
*
Yes
No
If not, who did?
*
AGREEMENT (PLEASE READ CAREFULLY BEFORE SIGNING)
I certify that all the information on this application is accurate and complete to the best of my knowledge and understand that misleading or false statements will constitute sufficient cause for refusal of hire or termination of my employment. I understand that neither the acceptance of this application nor the subsequent entry into any type of employment relationship with BLACKBURN BUILDING SERVICES creates an actual or implied contract of employment. I understand that, if I accept employment with BLACKBURN BUILDING SERVICES it will be on an at-will basis. This means that either BLACKBURN BUILDING SERVICES or I have the right to terminate the employment relationship at any time, for any reason, with or without cause. I agree to submit to drug and alcohol testing, and give my consent as required by BLACKBURN BUILDING SERVICES. I authorize and consent BLACKBURN BUILDING SERVICES to investigate information concerning my education, employment experiences and all other aspects of my background relevant to my proposed employment and certify that any information I give/have in this application is true and accurate.
Print your signature (printing your name if you agree)
*
First
Middle
Last
Todays Date
BLACKBURN BUILDING SERVICES is an equal employment opportunity employer. We adhere to a policy of making employment decisions without regard to race, color, religion, sex, sexual orientation, national origin, citizenship, age or disability. We assure you that your opportunity for employment with BLACKBURN BUILDING SERVICES depends solely on your qualifications.
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SERVICES
JANITORIAL
CARPET CLEANING
CLEANING & DISINFECTING
CAREERS
OPEN POSITIONS
Application
CONTACT