EmailMe Form - Employment Application

Name *

First Last

Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Email *

Phone *

### - ### - ####

Are You Legally Eligible for Employment in the U.S.? *

Yes

No

Resume (Optional)

Photo Upload *

Include a recent photo of yourself only if the link below does not include one.

Portfolio Link

Facebook, LinkedIn, or other professional sites designed to give us a glimpse of your talent are highly recommended. If you do not have one of these, please upload a photo using the above link.

Position Applying For: *

Line Worker

Manager Trainee

Admin Assistant

High School (Name/Location) *

Years Completed

1

2

3

High School Diploma or GED.

College/Trade School (Name/Location)

Subjects Studied or Degree Received:

Please List Any Skills You Have That Are Relevant For The Position You Are Applying For:

(Examples: Customer Service Experience, Equipment Maintenance, Sales, etc.)

PREVIOUS EMPLOYMENT

Or Check Here If No Work References

This Would Be My First Job

Most Recent Employer

Position Held

Beginning Date Of Employment:

MM / DD / YYYY

End Date Of Employment:

MM / DD / YYYY

Reason For Leaving

Currently Employed

Duties Performed:

Supervisor's Name

Phone

### - ### - ####

Second Previous Employer

Position Held

Beginning Date Of Employment:

MM / DD / YYYY

End Date Of Employment:

MM / DD / YYYY

Reason For Leaving

Duties Performed:

Supervisor's Name

Phone

### - ### - ####

REFERENCES *

(Please List 3 Professional References, Whom You Have Known at Least One Year. Include Their Names, Phone Numbers, and Their Relationship to You.)

How Far Do You Live From Wash Me Express? *

What Days and Times are you UNAVAILABLE to Work? *

Do You Smoke? *

No

Yes

Your Schedule at Wash Me Express Will Be Dependent Upon the Weather. If it Rains, You May Be Asked to Go Home Early or Work a Different Shift to Make Up Hours Lost Due to the Weather.
Please Check This Box to Acknowledge That You Understand This: *

I Understand

Tell Us A Bit About Yourself.

Any Hobbies That Occupy Your Time Away From Work?

Do You Have A Background That You Wish To Disclose Before We Run a Background Check? *

AUTHORIZATION

The information contained in this application is correct to the best of my knowledge. I hereby authorize Wash Me Express LLC and its designated agents and representatives to conduct a comprehensive review of my background causing a consumer report and/or an investigative consumer report to be generated for employment and/or volunteer purposes. I understand that the scope of the consumer report/ investigative consumer report may include, but is not limited to the following areas: verification of social security number; current and previous residences; employment history, education background, character references; drug testing, civil and criminal history records from any criminal justice agency in any or all federal, state, county jurisdictions; driving records, birth records, and any other public records.

I further authorize any individual, company, firm, corporation, or public agency (including the Social Security Administration and law enforcement agencies) to divulge any and all information, verbal or written, pertaining to me, to Wash Me Express LLC or its agents. I further authorize the complete release of any records or data pertaining to me which the individual, company, firm, corporation, or public agency may have, to include information or data received from other sources.

I hereby release Wash Me Express LLC, the Social Security Administration, and its agents, officials, representative, or assigned agencies, including officers, employees, or related personnel both individually and collectively, from any and all liability for damages of whatever kind, which may, at any time, result to me, my heirs, family, or associates because of compliance with this authorization and request to release.

Electronic Signature *

First Last

Date Of Birth *

MM / DD / YYYY