Position Applied For 
        * 
     
    
    Name
        * 
     
    
    Phone
        * 
     
    
    Alternative Phone
         
    
    How long have you lived here?
        * 
     
    
    Email
        * 
     
    
    Desired Salary/Hourly Rate
        * 
     
    
    Specify Hours
        * 
     
    
    Date you can start work if hired
        * 
     
    
    If yes, provide dates of applying.
        * 
     
    
    If yes, provide dates of employment, location and reason for  separation from employment.
        * 
     
    
    If applicable, below list any other names by which you have been known which may be necessary to allow us to confirm your work and educational record. For example, change of name, use of an assumed name, nickname, etc.
         
    
EDUCATION 
    High School
        * 
     
    
    Address
        * 
     
    
    Studied (Major)
        * 
     
    
    College
        * 
     
    
    Address
        * 
     
    
    Studied (Major)
        * 
     
    
    Trade School
        * 
     
    
    Address
        * 
     
    
    Studied (Major)
        * 
     
    
    List Degrees, Diplomas, and/or Certificates earned:
        * 
     
    
Employer 
    Name
        * 
     
    
    Address
        * 
     
    
    Type of Business
        * 
     
    
    Phone
        * 
     
    
    Dates Employed - From
        * 
     
    
    To
        * 
     
    
    Job Title
        * 
     
    
    Duties
        * 
     
    
    Supervisor's Name
        * 
     
    
    If No, why not?
        * 
     
    
    Wages - Start
        * 
     
    
    Final
        * 
     
    
    Reason for living?
        * 
     
    
    What will this employer say was the reason your employment terminated?
        * 
     
    
    Were you ever disciplined? If so, for what?
        * 
     
    
    How much notice did you give when resigning? If none, explain.
        * 
     
    
Employer 
    Name
         
    
    Address
         
    
    Type of Business
         
    
    Phone
         
    
    Dates Employed - From
         
    
    To
         
    
    Job Title
         
    
    Duties
         
    
    Supervisor's Name
         
    
    If No, why not?
         
    
    Wages - Start
         
    
    Final
         
    
    Reason for living?
         
    
    What will this employer say was the reason your employment terminated?
         
    
    Were you ever disciplined? If so, for what?
         
    
    How much notice did you give when resigning? If none, explain.
         
    
    If yes, how many times?
         
    
    If yes, how many times?
         
    
    If yes, how many times?
         
    
    If you answered Yes to any of the above three questions, please explain the circumstances of each occasion:
         
    
    
    
    Name
        * 
     
    
    Position
        * 
     
    
    Company
        * 
     
    
    Relationship
        * 
     
    
    Phone
        * 
     
    
    Name
         
    
    Position
         
    
    Company
         
    
    Relationship
         
    
    Phone
         
    
Please list the names of personal references (not previous employers or relatives) who you know that we may contact.
    Name
        * 
     
    
    Occupation
        * 
     
    
    Address
        * 
     
    
    Phone
        * 
     
    
    Years known
        * 
     
    
    Name
         
    
    Occupation
         
    
    Address
         
    
    Phone
         
    
    Years known
         
    
DRIVING INFORMATION 
    License #
        * 
     
    
    Exp. Date
        * 
     
    
    State
        * 
     
    		
		  CA Other 	 
	
    
    
    If you do not have a driver’s license for California, why not?
        * 
     
    
    If yes, explain:
        * 
     
    
    If no, explain:
        * 
     
    
    If yes, explain:
        * 
     
    
    Offense
        * 
     
    
    Date
        * 
     
    
    Location
        * 
     
    
    Comments
        * 
     
    
    Offense
         
    
    Date
         
    
    Location
         
    
    Comments
         
    
    Offense
         
    
    Date
         
    
    Location
         
    
    Comments
         
    
APPLICANT CERTIFICATION 
I understand and agree that if driving is a requirement of the job for which I am applying, my employment and/or continued employment is contingent on possessing a valid driver's license for the state in which I reside and automobile liability insurance in an amount equal to the minimum required by the state where I reside. I understand that ShineBrite Premier Cleaning Services LLC may now have, or may establish, a drug-free workplace or drug and/or alcohol testing program consistent with applicable federal, state, and local laws. If ShineBrite Premier Cleaning Services LLC has such a program and I am offered a conditional offer of employment, I understand that if a pre-employment (post-offer) drug and/or alcohol test is positive, the employment offer may be withdrawn. I agree to work under the conditions requiring a drug-free workplace, consistent with applicable federal, state, and local law.
APPLICANT CERTIFICATION
SHINEBRITE PREMIER CLEANING SERVICES LLC IS AN AT-WILL EMPLOYER AS ALLOWED BY APPLICABLE STATE LAW. THIS MEANS THAT REGARDLESS OF ANY PROVISION IN THIS APPLICATION, IF HIRED, SHINEBRITE PREMIER CLEANING SERVICES LLC OR I MAY TERMINATE THE EMPLOYMENT RELATIONSHIP AT ANY TIME, FOR ANY REASON, WITH OR WITHOUT CAUSE OR NOTICE. NOTHING IN THIS APPLICATION OR IN ANY DOCUMENT OR STATEMENT, WRITTEN OR ORAL, SHALL LIMIT THE RIGHT TO TERMINATE EMPLOYMENT AT-WILL. NO OFFICER, EMPLOYEE OR REPRESENTATIVE OF SHINEBRITE PREMIER CLEANING SERVICES LLC IS AUTHORIZED TO ENTER INTO AN AGREEMENT—EXPRESS OR IMPLIED—WITH ME OR ANY APPLICANT FOR EMPLOYMENT FOR A SPECIFIED PERIOD OF TIME UNLESS SUCH AN AGREEMENT IS IN A WRITTEN CONTRACT SIGNED BY THE PRESIDENT OF SHINEBRITE PREMIER CLEANING SERVICES LLC. IF HIRED, I AGREE TO CONFORM TO THE RULES AND REGULATIONS OF SHINEBRITE PREMIER CLEANING SERVICES LLC, AND I UNDERSTAND THAT SHINEBRITE PREMIER CLEANING SERVICES LLC HAS COMPLETE DISCRETION TO MODIFY SUCH RULES AND REGULATIONS AT ANY TIME, EXCEPT THAT IT WILL NOT MODIFY ITS POLICY OF EMPLOYMENT AT-WILL.
 
FOR CALIFORNIA APPLICANTS ONLY:  BY CHECKING THIS BOX, I WAIVE MY RIGHT TO RECEIVE A COPY OF ANY PUBLIC RECORD OBTAINED BY SHINE BRITE PREMIER CLEANING SERVICES FOR EMPLOYMENT PURPOSES THROUGH AN INTERNAL INVESTIGATION.
    Signature (type name)
        * 
     
    
    Date
        * 
     
    
If the applicant is a minor, the foregoing release and consent must be signed by the applicant's parent or legal guardian. Signature by the applicant's parent or legal guardian constitutes acknowledgement by the applicant and the parent or legal guardian that ShineBrite Premier Cleaning Services LLC, to the extent permitted by federal, state, and local law, can test the applicant for illegal or controlled substances, conduct inspections of property without notice, and communicate test results to ShineBrite Premier Cleaning Services LLC personnel who need to know, the applicant, and the applicant's legal guardian.
    Parental Guardian Signature (type name)
         
    
    Date
         
    
    Witness Signature (type name)
         
    
    Date