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CAREERS APPLICATION
Ready to Apply Online? Submit the Application below and We’ll Be in Touch!
PRE-EMPLOYMENT QUESTIONNAIRE AN EQUAL OPPORTUNITY EMPLOYER
Personal Information
Name
*
First
Middle
Last
Social Security No.
*
Phone
*
Address
*
Street Address
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
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
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Referred by:
*
Employment Information
Position Desired
*
Date You Can Start
*
MM slash DD slash YYYY
Salary Desired
*
Are you employed?
*
Yes
No
If so, may we call you present employer?
*
Yes
No
Have you ever applied with us before?
*
Yes
No
If so, where and when?
Have you ever worked at a dry cleaners before?
*
Yes
No
If so, where and when?
Education History
High School Name & Location
Years Attended
Did you graduate?
Subjects Studied
College Name & Location
Years Attended
Did you graduate?
Subjects Studied
Trade, Business or Correspondence Name & Location
Years Attended
Did you graduate?
Subjects Studied
Statement of Records
Have you ever been convicted of a felony?
*
Yes
No
When?
Explain:
Have you ever been accused of employer theft?
*
Yes
No
When?
Explain:
Former Employers
List your last four employers, starting with the most recent one first.
1. Name & Address of Employer
Start Date (Month & Year)
End Date (Month & Year)
Name of Supervisor
Phone
Salary/Wage
Position
Reason for Leaving
2. Name & Address of Employer
Start Date (Month & Year)
End Date (Month & Year)
Name of Supervisor
Phone
Salary/Wage
Position
Reason for Leaving
3. Name & Address of Employer
Start Date (Month & Year)
End Date (Month & Year)
Name of Supervisor
Phone
Salary/Wage
Position
Reason for Leaving
4. Name & Address of Employer
Start Date (Month & Year)
End Date (Month & Year)
Name of Supervisor
Phone
Salary/Wage
Position
Reason for Leaving
Authorization
I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for dismissal. I authorize investigation of all statements contained herein and the references and employers listed to give you any and all information concerning my previous employment and pertinent information they may have, personal or otherwise, and release the company from all liability for any damage that may result from utilization of such information.
Signature
*
Date
MM slash DD slash YYYY
Have questions about a career at Highland Cleaners?
Contact Us
today.
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