Apply at Laundry Land

Applicant Information

FirstLast

DateStreet Address

CityStateZIP

PhoneEmail

Date available to start training

Available Days & Times

Choose all that apply.

How many hours per week would you like to work?

Please select location preference

Why do you want to work here?

Are you a citizen of the United States?

YesNo

If no, are you authorized to work in the United States?

YesNo

Have you ever been convicted of a felony?

YesNo

If yes, explain

Education

High School

High School AttendedAddress

Beginning Date of High SchoolEnd Date of High School

Did you graduate?

YesNo

Activities

College

College AttendedAddress

Beginning Date of CollegeEnd Date of College

Did you graduate?

YesNo

Degree

Other Education

OtherAddress

Beginning DateEnd Date

Did you graduate?

YesNo

Degree

References

Please list 3 professional references

Reference 1

Full NameRelationshipCompanyPhoneAddress

Reference 2

Full NameRelationshipCompanyPhoneAddress

Reference 3

Full NameRelationshipCompanyPhoneAddress

Previous Employment

Job #1

CompanyPhoneAddressSupervisorJob Title

Starting SalaryEnding Salary

Responsibilities

Date StartedDate Ended

Reason for Leaving

May we contact your previous supervisor for a reference?

YesNo

Job #2

CompanyPhoneAddressSupervisorJob Title

Starting SalaryEnding Salary

Responsibilities

Date StartedDate Ended

Reason for Leaving

May we contact your previous supervisor for a reference?

YesNo

Job #3

CompanyPhoneAddressSupervisorJob Title

Starting SalaryEnding Salary

Responsibilities

Date StartedDate Ended

Reason for Leaving

May we contact your previous supervisor for a reference?

YesNo

Military Service

Branch

Date StartedDate Ended

Rank at DischargeType at DischargeIf other than honorable, explain

Emergency Contact Information

Please provide contact information in case of emergency.

FirstLast

Mobile PhoneWork PhoneHome PhoneRelationship to applicant

Disclaimer and Signature

I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.

SignatureDate