Apply — Office Care Inc. | Employment Application

1 Personal Information

First Name *Required

Middle

Last Name *Required

Street Address *Required

City *Required

State *Required

ZIP *Required

Mobile Phone *Required

Home Phone

Email *Enter a valid email

2 Position

Position Desired *Required

Salary Desired

Referred By

Date You Can Start *Required

3 Emergency Contact

Name *Required

Relationship

Phone *Required

4 Work Eligibility

Are you legally permitted to work in the USA? * YesNo

Can you provide two (2) forms of ID? * YesNo

Are you currently employed? YesNo

Have you ever applied to / worked for Office Care before? YesNo

5 Education Optional

Add any schooling you'd like us to know about.

6 Employment History Optional

List your most recent employers first (up to 4).

7 References Optional

Three people not related to you, known at least one year.

8 Review & Sign

I certify that the facts contained in this application are true and complete to the best of my knowledge, and understand that falsified statements shall be grounds for dismissal. I authorize investigation of all statements contained herein and release the company from all liability that may result from the use of such information. I understand that no representative of the company has authority to enter into any agreement for employment for any specified period of time. This waiver does not permit the release or use of disability-related or medical information in a manner prohibited by the Americans with Disabilities Act and other relevant laws.

Your Signature *

We'll review it and reach out about next steps.

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