Employment Application

Name*
First Last
Phone*
Alternate/Work Phone
Email*
Are you interested in*
- Full-Time
- Part-Time
- Temporary
Untitled*
- First Choice
- Second Choice
- Third Choice
What schedule would you prefer?*
- Weekdays
- Weekends
- Evenings
- Nights
How did you hear about the position?*
- Classified Ad
- Friend
- Radio
- Internet
Minimum pay:*
Desired pay:*
When are you able to start work? (Date):*
In what local area do you prefer to work?*
Position desired:*
Are you authorized to work in the United States?*
- yes
- no
Federal law requires that employers hire only individuals who are authorized to be lawfully employed in the United States. In compliance with these laws, UC CLEANING LLC will verify the status of every individual offered employment with the Company. In this connection, all offers of employment are subject to verification of the applicant’s identity and employment authorization, and it will be necessary for you to submit such documents as are required by law to verify your identification and employment authorization. UC CLEANING LLC is an equal opportunity employer and does not discriminate against any applicant or employee because of race, color, religion, sex, national origin, disability, age, or military or veteran status in accordance with federal law. In addition, UC CLEANING LLC complies with applicable state and local laws governing non‑discrimination in employment in every jurisdiction in which it maintains facilities. UC CLEANING LLC also provides reasonable accommodation to qualified individuals with disabilities in accordance with applicable laws.
Are you under 18 years of age?*
- yes
- no
If yes, can you furnish a work permit?*
- yes
- no
Are you capable of performing the essential functions of the job for which you are applying with or without a reasonable accommodation?*
- yes
- no

PLEASE LIST YOUR WORK EXPERIENCE BELOW (MOST RECENT JOB FIRST) Massachusetts applicants may include any verified work performed on a volunteer basis.
1st Company Name:*
Address:*
Phone Number:*
Your Position and Title:*
Start Date (Month, Year) to End Date (Month, Year):*
Supervisor's Name, Position, and Phone Number:*
Type of Business*
Salary/Hourly Pay:*
Briefly describe your job duties and reason for leaving:*

2nd Company Name:*
Address:*
Phone Number:*
Your Position and Title:*
Start Date (Month, Year) to End Date (Month, Year):*
Supervisor's Name, Position, and Phone Number:*
Salary/Hourly Pay:*
Type of Business*
Briefly describe your job duties and reason for leaving:*

3rd Company Name:*
Address:*
Phone Number:*
Start Date (Month, Year) to End Date (Month, Year):*
Your Position and Title:*
Supervisor's Name, Position, and Phone Number:*
Salary/Hourly Pay:*
Type of Business*
Briefly describe your job duties and reason for leaving:*

EDUCATION (Please list schools, colleges, prep)*
REFERENCES - Please list 3 professional references (Name, relationship, company, and phone number)*
By checking the box below I understand that this application is not an employment contract for any specific length of time between the Company and me, and that in the event I am hired, my employment will be “at will” and either the Company or I can terminate my employment with or without cause and with or without notice at any time. Nothing contained in any handbook, manual, policy and the like, distributed by the Company to its employees is intended to or can create an employment contract, an offer of employment or any obligation on the Company’s part. The Company may, at its sole discretion, hold in abeyance or revoke, amend or modify, abridge or change any benefit, policy practice, condition or process affecting its employees.*
- I understand
References: I hereby authorize the company and its agents to make such investigations and inquiries into my employment and educational history and other related matters as may be necessary in arriving at an employment decision. I hereby release employers, schools, and other persons from all liability in responding to inquires connected with my application and I specifically authorize the release of information by any schools, businesses, individuals, services or other entities listed by me in this form. Furthermore, I authorize the company and its agents to release any reference information to clients who request such information for purposes of evaluating my credentials and qualifications.*
- I consent
Temporary/Contract Employment: If employed as a temporary or contract employee, I understand that I may be an employee of the company and not of any client. If employed, I further understand that my employment is not guaranteed for any specific time and may be terminated at any time for any reason. I further understand that a contract will exist between the company and each client to whom I may be assigned which will require the client to pay a fee to the company in the event that I accept direct employment with the client, I agree to notify the company immediately should I be offered direct employment by a client (or by referral of the client to any subsidiary or affiliated company), either for a permanent, temporary (including assignments through another agency), or consulting positions during my assignment or after my assignment has ended.*
- I understand and agree
CAPTCHA

Step 1 of 5

PLEASE LIST YOUR WORK EXPERIENCE BELOW (MOST RECENT JOB FIRST) Massachusetts applicants may include any verified work performed on a volunteer basis.