Mandatory field Date (YYYY-MM-DD):*
Mandatory field Last Name:*
Mandatory field First Name:*
Middle Initial:
Mandatory field Email:*
Location Applied At:
Mandatory field Present Address:*
Mandatory field City:*
Mandatory field State:*
Mandatory field Zip Code:*
Mandatory field Phone#1:*
Phone#2:
How long have you lived at this address:
How long did you live at the previous address?
Previous address (if above is shorter than 3 years)
If hired, on what date will you be able to start work? (YYYY-MM-DD)
What are your present weekly income requirements?
Do you have a car available for full time use? Yes No
Make:
Year:
Emergency Contact Name:
Relationship:
Emergency Phone:
Emergency Address:
Mandatory field Date of Birth (YYYY-MM-DD):*
Mandatory field Sex?* Male Female
Mandatory field US Citizen?* Yes No
Mandatory field Marital Status?* Single Married Separated Divorced Widowed
Number of dependents living with you (not including yourself):
Is your spouse employed? Yes No
If so, where?
Spouse's Work Phone:
Mandatory field Check the box for the racial or ethnic group with which you identify:* Hispanic or Latino White Black or African American Native Hawaiian or Pacific Islander Asian American Indian or Alaska Native
Do you have any physical handicaps, which would prevent you from performing specific kinds of work? Yes No
If Yes, Please describe the defect(s) and explain your limitations.
Have you been injured or had a serious illness in the past 5 years? Yes No
If Yes, Please describe.
Have you ever been bonded? Yes No
Has a bond ever been cancelled? Yes No
Why?
Have you ever been convicted of a crime, excluding misdemeanors or summary offenses? Yes No
If Yes, Please explain.
Have you ever served in the Armed Forces? Yes No
Start Date of Duty (YYYY-MM-DD):
End Date of Duty (YYYY-MM-DD):
Rank at Discharge: N/A E1 E2 E3 E4 E5 E6 E7 E8 O1 O2 O3 O4 O5 O6 O7 O8
Describe you military duties.
Reason for Discharge.
1) Type of School:
School Name:
Graduated? Yes No
Course or Major:
2) Type of School:
School Name:
Graduated? Yes No
Course or Major:
3) Type of School:
School Name:
Graduated? Yes No
Course or Major:
Have you ever worked for a dry cleaner? Yes No
Who?
What were your job duties?
Why did you leave?
Have you ever worked for Albano Cleaners? Yes No
When?
Which Store?
Are there any other experiences, skills or qualifications that you have that you feel would fit for work with our company?
1) Employer Name & Address:
Dates:
Rate of Pay:
Supervisor's Name, Title, Phone#:
Reason for leaving:
Describe your duties:
2) Employer Name & Address:
Dates:
Rate of Pay:
Supervisor's Name, Title, Phone#:
Reason for leaving:
Describe your duties:
3) Employer Name & Address:
Dates:
Rate of Pay:
Supervisor's Name, Title, Phone#:
Reason for leaving:
Describe your duties:
EMPLOYMENT CONDITIONS (READ CAREFULLY)
I certify that all of the answers and statements made on this application are true,
complete, and correct to the best of my knowledge and belief, and that they are
made in good faith. I voluntarily give to the Company and to any of its representatives
the right to conduct a thorough investigation of my background ; and I release
from all liability or responsibility all persons, companies, and corporations supplying
such information. I understand that any false answer or statement made by me on
this application is sufficient cause for denial of employment and should falsification
be discovered after I have been employed, my service to the Company would be terminated.
I understand that the completion of this application does not in any way obligate the Company to employ me. I also understand that there is no guarantee of hours. Albano Cleaners workweeks are based on the sales volume for each week, hours will vary.
