APPLICATION FOR EMPLOYMENT
POWER CLEAN LLC
PRE-EMPLOYMENT QUESTIONNAIRE, EQUAL OPPORTUNITY EMPLOYER
1733 MARYVILLE PIKE
KNOXVILLE, TN 37920
NAME (LAST NAME FIRST)
DRIVERS LICENSE NO.
DATE YOU CAN START
ARE YOU CURRENTLY EMPLOYED?
IF SO, MAY WE CONTACT YOUR CURRENT EMPLOYER?
HAVE YOU APPLIED WITH US BEFORE?
NAME & LOCATION OF SCHOOL
TRADE, BUSINESS, CORR. SCHOOL
SPECIAL SKILLS, TRAINING AND OR SUBJECTS OF SPECIAL STUDY (One per line)
US MILITARY OR NAVAL SERVICE
(LIST BELOW LAST FOUR EMPLOYERS, STARTING WITH LAST ONE FIRST)
DATE, MONTH & YEAR
NAME & ADDRESS OF EMPLOYER
REASON FOR LEAVING
(BELOW LIST THREE PERSONS WITH NO RELATION, WHOM YOU HAVE KNOWN AT LEAST ONE YEAR)
Please copy and paste your resume into the field below:
By pressing the button below, I certify that the facts contained in this application are true and I have completed 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 ablove to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, 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 authority 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 an authorized company representative.
This waiver does not permit the release or use of disability-related information in a manner prohibited by the Americans with Disabilities Act (ADA) and other federal and state laws.