Location

Baton Rouge

New Orleans

Job Type

Full-Time

Position Summary

At assigned customer locations provided by the company, perform cleaning services as required. Maintain a high standard of customer service and additional sales performance.

General Information

First Name

Last Name

Email

Primary Phone

Secondary Phone

Current Address Information

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Personal Info

If the job requires, do you have the appropriate valid driver's license?

Yes No

Are you at least 18 years old?

Yes No

if under 18, hire is subject to verification that you are of the minimum age.

Present legal right to live and work in the country

Yes No

Employment History

I am a current employee of Coit Cleaning & Restoration

Do you have a resume?

Yes No

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Most Recent Employer

Are you currently working for this employer?

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May we contact

Yes No

Company Name

Supervisor

City/Town

State/Province

Phone Number

Fax Number

From Date

From Date: Month

From Date: Year

To Date

To Date: Month

To Date: Year

Job Title

Duties

Reason for Leaving

Second Most Recent Employer

Company Name

Supervisor

City/Town

State/Province

Phone Number

Fax Number

From Date

From Date: Month

From Date: Year

To Date

To Date: Month

To Date: Year

Job Title

Duties

Reason for Leaving

Approval

I certify that I have read and understand the applicant note on page one of this form and that the answers given by me to the foregoing questions and the statements made by me are complete and true to the best of my knowledge and belief. I understand that any false information, omissions or misrepresentations of facts called for in this application, whether on this document or not, may result in rejections of my application or discharge at any time during my employment. I authorize the company and / or its agents, to verify any of this information. I authorize all former employers, persons, schools, companies and law enforcement authorities to release any information concerning my background and hereby release any said persons, schools, companies and law enforcement authorities from any liability for any damage whatsoever for issuing this information. I also understand that the use of illegal drugs is prohibited during employment. If company policy requires, I am willing to submit to drug testing to detect the use of illegal drugs prior to and during employment.

Locally independently owned and operated.

Approval

Yes No

Technician in Louisiana