ROC/RightTouch Employment Form 

Conditions of employment are stated at the end of this form. Please read carefully before you submit this application. Your submission is your electronic signature.

Please Note: You must read and answer all questions on this application. Only applications completed correctly will be considered for Regular Full-time employment at ROC/RightTouch. Failure to complete the application correctly will disqualify you from being considered for Regular Full-time employment at ROC/RightTouch.

Application for Employment
 
ROC Commercial Cleaning/RightTouch Residential Cleaning
 
Position Applied For:
 *
Date Of Application:
 *
 
Personal Information
First Name:
 *
Middle Name:
 *
Last Name:
 *
Present Address:
 *
How Long:
 *
Home Telephone:
 *
Previous Address:
 *
How Long:
 *
Home Telephone:
 *
If No Phone How May We Contact You?
Any Friends Or Family Presently Employed With ROC?
Yes
No
If YES Name Of Friend or Relative:
Have You Ever Worked For The Company Before?
Yes
No
If YES Name of Supervisor and Approximate Date: MO/YR.
Have You Ever Applied To The Company Before?
Yes
No
If YES Approximate Date: MO/YR.
How Were You Referred To ROC Cleaners?
 *
 
General Information
If You Are Under Age 18 State Your Age
If Under Age 18 Can You Supply Working Papers?
Yes
No
Only U.S. Citizens or Aliens Who Have A Legal Right To Work In The U.S. Are Eligible For Employment. Can You Upon Employment Provide Genuine Documentation Establishing Your Identity And Eligibility To Be Legally Employed In the United States?
Yes
No
Have You Ever Been Convicted Of A Crime Or Violation Other Than A Minor Traffic Infraction?
Yes
No
A Conviction Record Will Not Necessarily Be A Bar To Employment. Factors Such As Job Relations Age And Time Of The Offense Seriousness And Nature Of Violation And Rehabilitation Will Be Taken Into Account.
 
If Yes Please Explain:
Conviction Explanation
Have You Ever Been Discharged From Any Employment Or Asked To Resign?
Yes
No
If Yes Please Explain:
Discharge Explanation
 
Please Check Schedule Availability: (Only One Please)
Full Time
Part Time
If Part Time Check Why: (Only One Please)
Student
Other Job
Other
If Other Please Explain:
My Other Explanation
Hours Available: (Check Only One)
AM
PM
 
List The Hours You Are Available For Each Day (To - From)
Monday
 *
Tuesday
 *
Wednesday
 *
Thursday
 *
Friday
 *
Saturday
 *
Sunday
 *
 
Note: Work Schedules Are Based Upon The Needs Of The Business And May Be Subject to Change On A Weekly Basis.
 
Wage Expected
 *
Available Start Date
 *
 
Employment History
 
Begin With Your Most Recent Employment [1] And Continue With All Past Employment
 
[1] Employer
1 Name Of Company
 *
1 Address
1 City State Zip
1 Phone Number
1 From Mo/Yr.
1 To Mo/Yr.
1 Salary Starting / Salary Ending
1 Type Of Business
1 Job Title
1 Describe Your Duties
1 Reason For Leaving (Please Explain)
1 Name And Title Of Immediate Supervisor
1 May We Contact Employer?
Yes
No
 
[2] Employer
2 Name Of Company
2 Address
2 City State Zip
2 Phone Number
2 From Mo/Yr.
2 To Mo/Yr.
2 Salary Starting / Salary Ending
2 Type Of Business
2 Job Title
2 Describe your Duties
2 Reason For Leaving (Please Explain)
2 Name And Title Of Immediate Supervisor
2 May We Contact Employer?
Yes
No
 
[3] Employer
3 Name Of Company
3 Address
3 City State Zip
3 Phone Number
3 From Mo/Yr.
3 To Mo/Yr.
3 Salary Starting / Salary Ending
3 Type Of Business
3 Job Title
3 Describe Your Duties
3 Reason For Leaving (Please Explain)
3 Name And Title Of Immediate Supervisor
3 May We Contact Employer?
Yes
No
 
Education
 
Name Of High School
Last Year Attended
9th
10th
11th
12th
Did You Graduate?
Yes
No
 
Name Of College
1 Subject Of Study
Last Year Attended
1st
2nd
3rd
4th
Did You Graduate?
Yes
No
1 Degree
 
Name Of Trade School / Business School
2 Subject Of Study
Last Year Attended
1st
2nd
3rd
4th
Did You Graduate?
Yes
No
2 Degree
 
Attendance And Punctuality Information
 
Consistent attendance and punctuality are essential requirements of every job with this company. Is there anything which would interfere with your regular attendance and punctuality if you are offered a job with the company?
Yes
No
 
If Yes Please Explain
 
Work / Personal References (2 References Required - 1 work and 1 personal non-relative)
 
1 Name
 *
1 Home Address
1 City State Zip
1 Home Phone
1 Work Phone
1 Title / Relationship
1 How Long Known
 
 
2 Name
 *
2 Home Address
2 City State Zip
2 Home Phone
2 Work Phone
2 Title / Relationship
2 How Long Known
 
 
3 Name
3 Home Address
3 City State Zip
3 Home Phone
3 Work Phone
3 Title / Relationship
3 How Long Known
 
 
I Acknowledge I Have Read The "NOTIFICATION AND AGREEMENT" Below
 
Signature (Type Your Full Name Here)
 *
Date (Type In Todays Date Here)
 *
Security code:
 *
Do not enter anything in this field:

* indicates a required field
 

Notification And Agreement

 

Please Read Before Submitting

Questions regarding this statement should be directed to any employment interviewer before signing/submitting . The application will be given every consideration, but its receipt does not imply that the applicant will be employed.

It is the policy of the company to afford equal opportunity to all employees and applicants for employment without regard to age, race, religion, color, sex, national origin, marital status, expunged juvenile records, or pregnancy, and to afford equal opportunities to disabled veterans, veterans of the Vietnam era, and individuals with a disability, any and other characteristic protected by Federal, State or Local law.

I authorize the investigation of all statements and information contained in this application. I release from all liability anyone supplying such information and I also release the employer from all liability that might result from making an investigation.

If hired, I agree to abide by all of the company rules and regulation, and understand that, if employed, my employment may be terminated with or without cause, and with or without notice, at any time, at the option of either the company or me, I further understand that no representation, whether oral or written by any representative or agent of the Company, at any time, can constitute a contract of employment. I understand that the Company and all Plan Administrators shall have the maximum discretion permitted by law to administer, interpret, modify, discontinue, enhance or otherwise change all policies, procedures, benefits or other terms or conditions of employment. No representative or agent of the company, has the authority to enter into any agreement for employment for any specified period of time or to make any change in any policy, procedure, benefit or other term or condition of employment other than in a document signed by the President of the Company, or to make any agreement contrary to the foregoing.

I acknowledge that I have read and understand the above statements and hereby grant permission to confirm the information supplied on this application by me.

 

 

I Certify That All Answers Given By Me Are True, Accurate And Complete; I Understand That The Falsification, Misrepresentation Or Omission Of Fact On This Application (Or Any Other Accompanying Or Required Documents) Will Be Cause For Denial Of Employment Or Immediate Termination Of Employment, Regardless Of When Or How Discovered.