Employment Application

We consider applicants for all positions without regard to race, color, religion, creed, gender, national origin, age, disability, marital or veteran status, sexual orientation, or any other legally protected status.WE ARE AN EQUAL OPPORTUNITY EMPLOYER
Job Category
Job Location
Position(s) Applied For*
Desired wage or salary range
How did you learn about us?
- Advertisement
- Employment Agency
- Internet
- Referral
- Job Fair
- Walk-In
- Other
If you selected "Other" above...
If you selected "Referral" above please enter the referrals name

Name and Address
Full Name*
First Middle Last
Address*
Street Address Address Line 2 City State ZIP Code
Home Phone
Cell Phone
Email Address*

Employment Experience
Employer
Supervisor
Hrs/week
Address
Street Address Address Line 2 City State ZIP Code
Start Date
MM slash DD slash YYYY
End Date
MM slash DD slash YYYY
Starting Salary
Ending Salary
Telephone Number(s)
Job Title
Reason for Leaving
Work Performed
Employer
Supervisor
Hrs/week
Address
Street Address Address Line 2 City State ZIP Code
Start Date
MM slash DD slash YYYY
End Date
MM slash DD slash YYYY
Starting Salary
Ending Salary
Telephone Number(s)
Job Title
Reason for Leaving
Work Performed
Employer
Supervisor
Hrs/week
Address
Street Address Address Line 2 City State ZIP Code
Start Date
MM slash DD slash YYYY
End Date
MM slash DD slash YYYY
Starting Salary
Ending Salary
Telephone Number(s)
Job Title
Reason for Leaving
Work Performed
Employer
Supervisor
Hrs/week
Address
Street Address Address Line 2 City State ZIP Code
Start Date
MM slash DD slash YYYY
End Date
MM slash DD slash YYYY
Starting Salary
Ending Salary
Telephone Number(s)
Job Title
Reason for Leaving
Work Performed
List professional, trade, business or civic activities and offices held.
You may exclude membership which would reveal gender, race, religion, national origin, age, ancestry, disability or other protected status.

References such as previous supervisor or co-worker who can provide professional references
Name
Phone
Address
Street Address Address Line 2 City State ZIP Code
Name
Phone
Address
Street Address Address Line 2 City State ZIP Code
Name
Phone
Address
Street Address Address Line 2 City State ZIP Code

Applicant's Statement
I specifically authorize Safari Contract Cleaners, and those acting on behalf of Safari Contract Cleaners, to investigate and/or make inquiry into my background as may be necessary in arriving at an employment decision, including, but not limited to, a criminal background check, a consumer reporting agency report, an MVR (motor vehicle report) and workman’s compensation activity report. I release Safari Contract Cleaners from any liability, including a potential claim for defamation, related to the completion or undertaking of my pre-employment background check. This application for employment shall be considered active for a period of time not to exceed 6 months. Any applicant wishing to be considered for employment beyond this time period should inquire as to whether or not applications are being accepted at that time. I hereby understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with this organization is of an "at will" nature, which means that the Employee may resign at any time and the Employer may discharge Employee at any time with or without cause. It is further understood that this "at will" employment relationship may not be changed by any written document or by conduct unless such change is specifically acknowledged in writing by an authorized executive of this organization. In the event of employment, I understand that false or misleading information given in my application or inter-view(s) may result in discharge. If employed, I agree to abide by all policies, rules and procedures of the Employer. I also understand that I may be required to take a drug test or participate in a random drug pool as a condition of employment. I hereby authorize the use of photocopies of this section of the application for employment for acceptance by all persons and parties as an original for the release of any and all information that is relevant to the consideration of the application of employment. I agree to release all such persons and parties from any claim or liability for providing such information to the company.
Signature of Applicant*
Please enter your full name to electronically sign this application.
Date*
MM slash DD slash YYYY
Date Of Birth*
MM slash DD slash YYYY
Comments
This field is for validation purposes and should be left unchanged.

Safari Work Requirements

Name and Address

Additional Information

Education

Employment Experience

Additional Skill Information

References such as previous supervisor or co-worker who can provide professional references

Affirmative Action Data Record

Applicant's Statement

Commercial Services