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Employment Application

Midnight Janitorial of Rochester, NY is an equal opportunity employer, always seeking high energy good people.

Job Applying For: (required)

How did you learn about this opening? (required)

Date you could start: (required)

Rate Desired (required)

Personal Information

Full Name (required)

Street Address (required)

Street Address 2

City (required)

State (required)

Zip Code (required)

Phone Number (required)

Mobile Number (required)

Work Number

Email Address (required)

Are you over 21?
YesNo

For the purpose of compliance with the United States
Immigration and Nationalization Act: Are you legally
eligible for employment in the United States?
YesNo

Were you previously employed by Midnight Janitorial,
Inc.?
YesNo

Do you have a valid drivers license?
YesNo

Have you ever been fired or resigned from a position
after being notified you would be fired?
YesNo

Please select the boxes that correspond to the evenings
that you are available to work:
MondayTuesdayWednesdayThursdayFridaySaturdaySunday

Can you read and understand instructions written in
English?
YesNo

Do you have dependable transportation of your own?
(Bus transportation does not qualify)
YesNo

Are you related to anyone employed by Midnight
Janitorial, Inc.?
YesNo

Do you have prior cleaning experience?
YesNo

References

Please give the names of 3 persons NOT related to you, whom you have known at least one year.

Reference #1: Name

Reference #1: Phone Number

Reference #1: Years Known

Reference #1: Occupation

Reference #2: Name

Reference #2: Phone Number

Reference #2: Years Known

Reference #2: Occupation

Reference #3: Name

Reference #3: Phone Number

Reference #3: Years Known

Reference #3: Occupation

Present Employer

Place of Employment

Address

Name of Supervisor

Phone Number

Emergency Contact(s)

Name

Relation

Phone

Name

Relation

Phone

Education

High School Name & Location

High School Start Date

High School End Date

Degree

Area of Study / Other Notes

College Name & Location

College Start Date

College End Date

Degree

Area of Study / Other Notes

Additional College Name & Location

Additional College Start Date

Additional College End Date

Degree

Area of Study / Other Notes

Business / Trade School Name & Location

Business / Trade School Start Date

Business / Trade School End Date

Degree

Area of Study / Other Notes

If you expect to complete an educational program in the near future, please indicate what type of degree and when you expect to receive it:

Employment History

Employer Name

Employer Address

Employer Phone Number

Position Held

Dates of Employment

Supervisor

Employer Name

Employer Address

Employer Phone Number

Position Held

Dates of Employment

Supervisor

Employer Name

Employer Address

Employer Phone Number

Position Held

Dates of Employment

Supervisor

Employer Name

Employer Address

Employer Phone Number

Position Held

Dates of Employment

Supervisor

Employer Name

Employer Address

Employer Phone Number

Position Held

Dates of Employment

Supervisor

I cetify that the statements in this application are true and complete to the best of my knowledge, and I agree that misstatement or omission will constitute grounds for unfavorable consideration of my application or dismissal from Midnight Janitorial, Inc. I authorize Midnight Janitorial, Inc. to obtain information from past employers and other on this application, including a review of my educational, criminal and credit records, as appropriate.

You may contact my PRESENT employer
YesNo

I understand and agree that my employment is for no definite period and may, regardless of the date of payment of terminated at any time without any previous notice. I understand that upon being hired I will be subject to a background check.

Today's Date

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