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Crystal Dove Cleaning Pam Beach / Owner P.O. Box 407 Morro Bay, CA 93443 (805) 459-8468 (call or text) pam@crystaldovecleaning.com Applicant Name Age Home Phone Cell Phone Email Address Current Address: Number and street City State & Zip How were you referred to Company?: Positions Position(s) applying for: Are you applying for: Temporary part-time work – such as summer or holiday work? [ ] Y or [ ] N Regular part-time work? [ ] Y or [ ] N If applying for temporary work, when will you be available? If hired, on what date can you start working? Can you work on the weekends? [ ] Y or [ ] N Can you work evenings? [ ] Y or [ ] N Personal Information: Have you ever applied to / worked for Company before? [ ] Y or [ ] N If yes, please explain (include date): If hired, would you have transportation to/from work? [ ] Y or [ ] N Are you over the age of 18? If under 18, do you have working papers? [ ] Y or [ ] N If hired, would you be able to present evidence of your U.S. citizenship or proof of your legal right to work in the United States? [ ] Y or [ ] N If hired, are you willing to submit to and pass a controlled substance test? [ ] Y or [ ] N Have you ever been convicted of a criminal offense (felony or misdemeanor)? [ ] Y or [ ] N If yes, please state the nature of the crime(s), when and where convicted and disposition of the case. (Note: No applicant will be denied employment solely on the grounds of conviction of a criminal offense. Days/Hours Available Monday Tuesday Wednesday Thursday Friday Saturday Sunday Hours Available: What date are you available to start work? EMPLOYMENT HISTORY: Present Or Last Position: Employer: Address: Supervisor: Phone: Email: Position Title: From: To: Responsibilities: Salary: Reason for Leaving: =========== Previous Position: Employer: Address: Supervisor: Phone: Email: Position Title: From: To: Responsibilities: Salary: Reason for Leaving: May We Contact Your Present Employer? Yes No References: List Three (3) Name, Address, Phone, Relationship I certify that information contained in this application is true and complete. I understand that false information may be grounds for not hiring me or for immediate termination of employment at any point in the future if I am hired. I authorize the verification of any or all information listed above. Signature Date