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Download Employee Application Form or fill up the same form below.

    Completely Clean Laurel Application For Employment

    Name:      Date:
    Current Address:
    SS#: - - Email:
    Cel#:   () - -                  Position applying for:
    Salary Desired: $. per           Date Available:
    Employment Type Desired: Availability: How did you hear about position? :
    Name of employee referred by:
    Have you applied before? YesNo         Have you worked here before? YesNo
    If you've worked here before, please give details:
    Have a valid driver's license? YesNo       License#:
    List of your computer skills:

    Education (most recent first, include technical schools)


    School Name:   
    Attended:           to      Graduate? YesNo
    Degree Earned:

    School Name:   
    Attended:           to      Graduate? YesNo
    Degree Earned:
    School Name:   
    Attended:           to      Graduate? YesNo
    Degree Earned:

    Employment History


    Employer:
    Phone#:   ()--
    Dates Employed: to
    Your Title:   Salary start $. end $.
    Supervisor: Supervisor's Title:
    Responsibilities:      
    Reason for leaving:

    Employer:
    Phone#:   ()--
    Dates Employed: to
    Your Title:   Salary start $. end $.
    Supervisor: Supervisor's Title:
    Responsibilities:      
    Reason for leaving:

    Employer:
    Phone#:   ()--
    Dates Employed: to
    Your Title:   Salary start $. end $.
    Supervisor: Supervisor's Title:
    Responsibilities:      
    Reason for leaving:

    Employer:
    Phone#:   ()--
    Dates Employed: to
    Your Title:   Salary start $. end $.
    Supervisor: Supervisor's Title:
    Responsibilities:      
    Reason for leaving:

    Have you ever been convicted of a crime, had adjudication withheld, prosecution deferred, pled guilty or no contest to a crime, been convicted of a crime or have any criminal charges currently pending? Include minor traffic violations and DWI’s/DUI’s. Include all misdemeanor and felony convictions. Do not include sealed or expunged convictions. Conviction will not bar you from employment. Each instance considered in relation to position applied for. YesNo

    If yes, please explain providing dates & details

    Statement of Application

          I certify the information provided in this application is true and correct to the best of my knowledge and that falsification or omission of information is grounds for my dismissal. I understand this application will be considered, but does not imply I will be employed. I understand if hired, my employment will be for no specific period of time. I understand I have the right to terminate my employment without notice or reason and the company reserves the same right.