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Home
Community
Photos
Directions
History
Employment
Contact
Employment Application Form
Name
*
First Name
Last Name
Email Address
*
Today's Date
*
MM
DD
YYYY
Your Phone number
*
(###)
###
####
Your Home Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
If offered a position with Springfield Plaza Laundromat & Cleaners, my intention is to work here for
*
Less than 3 months
3 to 6 months
6 months to 1 year
At least 1 year
Have you ever been discharged from your employment? If "YES" please explain
*
Have you ever been convicted of a felony or have you ever been charged with a crime of moral turpitude, "lying, cheating, stealing (shop lifting)"?
*
Describe your most significant accomplishment during your past employment
*
What motivated you to apply at Springfield Plaza Laundromat & Cleaners?
*
What separates you from the next candidate for this position?
*
On average, ideally how many hours would you like to work per week?
*
Is your schedule flexible?
*
Yes
No
What hourly salary would you be very happy with?
*
$
What is your work availability?
*
Are you legally eligible for employment in the USA?
*
PROOF OF U.S CITIZENSHIP OR IMMIGRATION STATUS WILL BE REQUIRED UPON EMPLOYMENT
Yes
No
Can you work overtime?
*
Yes
No
How did you hear that we are hiring?
*
I spoke to a staff member
Craigslist
Our Website
Friend or Family
In Store
Other
If employed may we inquire of your present employer?
*
Yes
No
Do you understand that the illegal use of drugs is prohibited during employment?
*
Yes
No
Do you understand that the illegal use of drugs is prohibited during employment?
*
Yes
No
I UNDERSTAND THAT IN ACCORDANCE WITH COMPANY POLICY, FAILING A SUBSTANCE ABUSE TEST MAY PREVENT CONTINUED EMPLOYMENT OR CONSIDERATION FOR EMPLOYMENT BY THE COMPANY.
*
Yes
EDUCATION AND TRAINING
High school name
*
High school years completed
*
High school graduation date or GED
*
COLLEGE
College name
College city and state
College years completed
College graduation date
College course or major
ADDITIONAL TRAINING
Type of additional training
City and state of additional training
Years completed of additional training
Graduation date of additional training
EMPLOYMENT SECTION
Please list your current or most recent employment first.
Are you currently employed?
*
Yes
No
Employer 1 (Business Name)
*
Employer 1 Location (City and State)
*
Employer 1 (Telephone number)
*
(###)
###
####
Employer 1 (Position)
*
Employer 1 Start Date (current or most recent job)
*
MM
DD
YYYY
Employer 1 End Date. If currently working here, please write today's date
*
MM
DD
YYYY
Employer 1 (Starting Hourly Salary)
*
$
Employer 1 (Current or Ending Hourly Salary)
*
$
Employer 1 (Supervisor's Name)
*
Employer 1 (Reason for Leaving) If currently working here, please respond with "still here"
*
Employer 1 (If currently employed, are your intentions to work 2 jobs or to leave your current job)
*
I am not currently employed
I would like to work 2 jobs
I would like to work for you only
Employer 2 (Business Name)
Employer 2 Location (City and State)
Employer 2 (Telephone number)
(###)
###
####
Employer 2 (Position)
Employer 2 Start Date
MM
DD
YYYY
Employer 2 End Date. If currently employed here, please respond with "still here".
Employer 2 (Starting Hourly Salary)
$
Employer 2 (Ending Hourly Salary)
$
Employer 2 (Supervisor's Name)
Employer 2 (Reason for Leaving)
Employer 3 (Business Name)
Employer 3 Location (City and State)
Employer 3 (Telephone number)
(###)
###
####
Employer 3 (Position)
Employer 3 Start Date
MM
DD
YYYY
Employer 3 End Date
MM
DD
YYYY
Employer 3 (Starting Hourly Salary)
$
Employer 3 (Ending Hourly Salary)
$
Employer 3 (Supervisor's Name)
Employer 3 (Reason for Leaving)
EMPLOYER 4
Employer 4 (Business Name)
Employer 4 Location (City and State)
Employer 4 (Telephone number)
(###)
###
####
Employer 4 (Position)
Employer 4 Start Date
MM
DD
YYYY
Employer 4 End Date
MM
DD
YYYY
Employer 4 (Starting Hourly Salary)
$
Employer 4 (Ending Hourly Salary)
$
Employer 4 (Supervisor's Name)
Employer 4 (Reason for Leaving)
Congratulations, you are almost finished! One last question. What type of device did you complete this online application with? Phone, Tablet, Computer, etc...
*
AUTHORIZATION “I CERTIFY THAT THE FACTS CONTAINED IN THIS APPLICATION ARE TRUE AND COMPLETE TO THE BEST OF MY KNOWLEDGE AND UNDERSTAND THAT, IF EMPLOYED, FALSIFIED STATEMENTS ON THIS APPLICATION SHALL BE GROUNDS FOR DISMISSAL. I AUTHORIZE INVESTIGATION OF ALL STATEMENTS CONTAINED HEREIN AND THE REFERENCES AND EMPLOYERS LISTED ABOVE TO GIVE YOU ANY AND ALL INFORMATION CONCERNING MY PREVIOUS EMPLOYMENT AND ANY PERTINENT INFORMATION THEY MAY HAVE, PERSONAL OR OTHER WISE, AND RELEASE THE COMPANY FROM ALL LIABILITY FOR ANY DAMAGE THAT MAY RESULT FROM UTILIZATION OF SUCH INFORMATION. I ALSO UNDERSTAND AND AGREE THAT NO REPRESENTATIVE OF THE COMPANY HAS ANY AUTHORIZATION TO ENTER INTO ANY AGREEMENT FOR EMPLOYMENT FOR ANY SPECIFIED PERIOD OF TIME, OR TO MAKE ANY AGREEMENT CONTRARY TO THE FOREGOING, UNLESS IT IS IN WRITING AND SIGNED BY THE COMPANY PRESIDENT. SPRINGFIELD PLAZA LAUNDROMAT AND CLEANERS FOLLOWS THE TRADITIONAL, COMMON-LAW THEORY OF "EMPLOYMENT-AT-WILL". THAT THEORY IS: AN EMPLOYEE CAN QUIT ANY JOB AT ANY TIME WITHOUT GIVING THEIR EMPLOYER A REASON FOR THEIR DECISION OR ANY ADVANCE NOTICE THAT THEY ARE LEAVING; SIMILARLY, AN EMPLOYER CAN END THE RELATIONSHIP WITHOUT NOTICE OR REASON. I ALSO UNDERSTAND THAT MY TERMS OF EMPLOYMENT CAN BE CHANGED AT ANY TIME, WITH OR WITHOUT CAUSE OR NOTICE, BY THIS ORGANIZATION. I ALSO UNDERSTAND THAT I AM REQUIRED TO ABIDE BY ALL RULES AND REGULATIONS OF THIS EMPLOYER.”
By checking this box and typing my name below, I am electronically signing my application for employment at Springfield Plaza Laundromat and Cleaners
*
*
First Name
Last Name
Thank you!