Shur-Shine Janitorial Service
"When You Shine, We Shine"
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Online Application

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Name *
E-mail Address *
Middle Initial: *
Last Name: *
Address: *
City: *
State: *
Zip Code:
Phone: *
Date of Birth: *
Position Applying for:
Date You Can Start:
Salary desired:
Are You Employed? *
If So, May We Inquire of Your Present Employer? *
Ever Applied To This Company Before? *
Where?
When?
Education History:
High School: *
Years Attended: *
Did You Graduate? *
Subjects Studied: *
College: *
Subjects Studied: *
Years Attended: *
Did You Graduate? *
Subjects of Special Study/Research Work or Special Training/Skills
Former Employers: Please list the last three employers and all pertinent information.
Name & Address of Employer
From
To:
Salary
Position
Reason for Leaving
Name & Address of Employer
From
To:
Salary:
Position
Reason for Leaving
Name & Address of Employer
From
To
Salary
Position
Reason for Leaving
Reference/Name/Phone/Business/Years Known *
Reference/Name/Phone/Business/Years Known *
Reference/Name/Phone/Business/Years Known *
Emergency Contact Information *
Today's Date: *
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 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 otherwise, and release the company from all liability. *


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