More than clean. Cleary.

Cleary Cleaners

Application for Employment
Date of Application:
Position Applying For:
Date Available To Start:
Salary Desired:
Desired Schedule:
Check Days Available: SunMonTueWedThuFriSat
Full TimePart TimeTemporary
Hours Available Each Day:
Comments:

Personal Information:

Last Name:
First Name:
Middle Name:
Present Address:
City:
State:
Zip:
Previous Address:
City:
State:
Zip:
Daytime Phone:
Evening Phone:
Are you over 18?: YesNo

Employment History:

List employment, starting with your most recent position. Account for any time during this period in which you were unemployed by stating the nature of your activities. If you have no prior employment history, include personal references to be contacted.

MAY WE CONTACT YOUR EMPLOYER: YesNo
Employer:
Position Title:
Dates:   from
to
Address:
City:
State:
Telephone:
Supervisor:
Reason For Leaving:
Hourly Rate/Salary:   Starting
Final
Duties Performed:  

Employer:
Position Title:
Dates:   from
to
Address:
City:
State:
Telephone:
Supervisor:
Reason For Leaving:
Hourly Rate/Salary:   Starting
Final
Duties Performed:  

Employer:
Position Title:
Dates:   from
to
Address:
City:
State:
Telephone:
Supervisor:
Reason For Leaving:
Hourly Rate/Salary:   Starting
Final
Duties Performed:  

Education:

List Types of School, Name and Location of School, Degree Area of Study, and # of Years Completed:

High School:
Name:
City:
State:
Degree Area of Study:
# of Years Completed:
Graduated?: YesNo

College:
Name:
City:
State:
Degree Area of Study:
# of Years Completed:
Graduated?: YesNo


Other:
Name:
City:
State:
Degree Area of Study:
# of Years Completed:
Graduated?: YesNo

Special Skills, Activities, and Achievements:

TypingWord ProcessingCustomer Service
Summarize any special training, skills, licenses, certificates and or/ characteristics that may qualify you as being able to perform job-related functions for the position which you are applying.

Miscellaneous:

Have you ever been employed by Cleary Cleaners?   YesNo
Dates Employed: From:
To
Supervisor:
Have you ever been convicted of a crime?   YesNo
(Convicted of a crime does not automatically disqualify an application from consideration)
If yes, please explain:
Are there any jobs which you do not wish to be considered? Please explain:

Please Read this Statement Carefully:

I hereby affirm that the information given by me on this application for employment is complete and accurate. I understand that any falsification will be immediate grounds for dismissal. I authorize a through investigation to be made in connection with this application concerning my character, general reputation, personal characteristics, employment, education, background and criminal record, whichever may be applicable. I understand that this investigation may include personal interviews with third parties such as family member, business associates, financial sources, friends, neighbors, and others with whom I am acquainted.

It is my understanding that as a prerequisite to consideration for employment, I must agree to submit to any post employment examination, physical or other, as the Company may lawfully require.

I understand and agree that any falsification or omission either on this form or to my response to questions asked during any interview examination process is grounds for immediate termination with or without cause and without notice at any time, at the option of Cleary Cleaners or myself. I understand that no representative of Cleary's other than a member of the Executive Committee has the authority to enter into any agreement for the any specified period of time or to make agreement contrary to the foregoing. I further understand that I have the right to make a written request within a reasonable period of time for a complete and accurate disclosure of the nature and scope of the investigation. I have read and affirm as my own the above statements.

Signature:

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Job Applicant Availability Questionnaire:

Cleary Cleaners has locations throughout Southern New Hampshire. In order to better assess your fit for a certain job offering, please tell us about your ability to travel to the following locations and about your schedule flexibility.


Travel - Cleary Cleaners has stores in the following towns/cities. Please check the appropriate column beside each location.

Location
Available to travel on a daily basis if needed
Available to travel ocassionally if needed
Unable to travel to this location
(Explain below)

Rochester: Available to travel on a daily basis if neededAvailable to travel ocassionally if neededUnable to travel to this location
Dover: Available to travel on a daily basis if neededAvailable to travel ocassionally if neededUnable to travel to this location
Durham: Available to travel on a daily basis if neededAvailable to travel ocassionally if neededUnable to travel to this location
Portsmouth: Available to travel on a daily basis if neededAvailable to travel ocassionally if neededUnable to travel to this location
Greenland: Available to travel on a daily basis if neededAvailable to travel ocassionally if neededUnable to travel to this location
Stratham: Available to travel on a daily basis if neededAvailable to travel ocassionally if neededUnable to travel to this location
Hampton: Available to travel on a daily basis if neededAvailable to travel ocassionally if neededUnable to travel to this location
Manchester/Bedford: Available to travel on a daily basis if neededAvailable to travel ocassionally if neededUnable to travel to this location
Concord: Available to travel on a daily basis if neededAvailable to travel ocassionally if neededUnable to travel to this location

Please explain any checkmarks in the "Unable to travel" column:

Schedule - Please check the appropriate box below to describe your flexibility in scheduling:

 I realize that Cleary stores are open from 7 AM to 7 PM Monday through Friday and Saturdays 8 AM to 2 PM (Saturday schedule may vary in some stores and a couple of stores have Sunday hours.) I am available any and all of the hours above if needed. I am interested only in a part time position and can only work the hours being discussed for that specific position.                                 My availability is limited:

(please explain):


Please print name

Sign Name

Date:

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Information for Job Applicants Regarding Cleary Cleaners
Smoking and Substance Abuse Policy:

Smoking
Cleary Cleaners promotes a smoke free environment for your good health. We respect the rights of individuals to smoke if they choose. However, we must also take into consideration the rights of non-smokers to be protected from second-hand smoke and State law regarding smoking in the workplace. Therefore, there is no smoking allowed in any area of any company building per Cleary Cleaners policy and State law. This extends to our delivery vehicles and the immediate grounds outside of our buildings. An exception is at our Rochester Production facility where there is a designated smoking area away from the building.

We want you to know about and understand this policy before you apply for employment so that there is no misunderstanding at a later date. If you have any questions about the policy, please ask for clarification before accepting a position if it is offered to you.

As a practical matter, this means that if you are a smoker, you may not be able to smoke at any time during your work shift. For instance, if you are covering a sales counter alone for a 9 hour shift, you will be unable to smoke during that time since you cannot leave the building unattended.

Substance Abuse
Cleary Cleaners reserves the right to require a pre-employment drug screening and random drug testing during your term of employment.


I have read and understand the policies above.
Please sign below and return with your application.


(Signed)


(Date)