Part-Time Maintenance Clerk

Position requires the cleaning of restrooms (both customer and employees) on an hourly basis,
maintaining waste baskets for entire store and responding to calls for store clean up issues.
Responsible for maintaining clean floors throughout the store to ensure customer and employee
safety measures are met. Handling minor maintenance of store fixtures which may entail painting,
using tools or plumbing, etc. May be required to use a stem heated pressure washer to clean store sidewalks
and receiving dock areas. Continued maintenance of the store's recycling programs and compost programs.
Must have great follow through skills and excellent communication skills; ability to stand
for long periods of time; able to lift items weighing over 50 pounds.

Dependability, reliability and team work a must!

An Equal Opportunity Employer
We do not discriminate on the basis of race, color, religion, national origin, sex, age, disability, or any other status
protected by law or regulation. It is our intention that all qualified applicants be given equal opportunity and that
selection decisions will be based on job-related factors.

Answer each question fully and accurately.
No action can be taken on this application until you have answered all questions.
In reading and answering the following questions, be aware that none of the questions
are intended to imply illegal preference or discrimination based upon non-job-related information.

PLEASE FILL IN COMPLETELY
Today's Date:  
First Name:       Last Name: 
     
E-Mail Address: 

Phone Number:  

Street Address:  
City, State, Zip:  
IF HIRED, CAN YOU FURNISH PROOF THAT YOU ARE ELIGIBLE TO WORK IN THE UNITED STATES?
Yes:      No:  
   
Have you applied here before? Yes:      No:  
If yes, when?
Were you ever employed here? Yes:      No:  
If yes, when?
   
Total hours you can work per week?    Date you can start?
Salary Expectation?:  
 
Please briefly describe your qualifications for  
the positions you prefer:  
(HOURS OF OPERATION WILL BE: 7AM TO 10PM DAILY)

Hours you are available to work:  

 

We will make an effort to accommodate
employees’ schedule needs,
but we cannot guarantee
a set or specific work schedule.
EDUCATION
High School or GED (Name, Location):  
Years completed
College or University
Years completed
Diploma or Degree
Vocational or Technical:  
Years completed
Diploma or Degree
Advanced and/or Specialized Education:  
Years completed
Diploma or Degree
For Driving Jobs Only:  Do you have a valid drivers license? Yes:  No:
   

Have you ever been convicted of any law violation?
(Include any plea of "guilty" or "no contest". Exclude minor traffic violations)
(A conviction will not necessarily disqualify
an applicant for employment).
Please list details:  
       
List employers in consecutive order with present or last employer listed first. Account for all periods of time. Note: A job offer may be contingent upon acceptable references from current or past employers
Employment History
Latest Employer:

Name

Address

City, State, Zip

Phone Number

Supervisor Name & Title

Position Title & Dates held

Position Duties

Pay (starting & ending)
Dates of employment

Reason For Leaving

Previous Employer:

Name

Address

City, State, Zip

Phone Number

Supervisor Name & Title

Position Title & Dates held

Position Duties

Pay (starting & ending)

Dates of employment

Reason For Leaving

Previous Employer:

Name

Address

City, State, Zip

Phone Number

Supervisor Name & Title

Position Title & Dates held

Position Duties

Pay (starting & ending)

Dates of employment

Reason For Leaving
 PLEASE ACCOUNT FOR any periods of
unemployment, with specific details 
Are you presently employed? Yes:    No:

Please attach your resume here

 
   
Would it be acceptable to contact your current employer?

Yes:    No:

If yes, whom do you suggest we contact?
   
Have you ever been fired from a job or asked to resign? Yes:    No:
If yes, please explain
   
   
Tell of a time when you provided extraordinary customer service:  
   
Do you have or have you ever had any physical or other
limitation that would prevent you from doing the job
for which you are applying, including
lifting heavy boxes (over 25lbs.) etc.
If so, pelase describe:  
Have you worked or attended school under any other names? Yes:    No:
If yes, give names
   
Please list three references, not relatives or personal friends


Name

Address

Phone


Name

Address

Phone


Name

Address

Phone

 

AFFADAVIT, CONSENT AND RELEASE

Please read the following statements carefully before submitting:

I certify that all information provided in this employment application is true and complete. I understand that any false information or omission may disqualify me from further consideration for employment and may result in my dismissal if discovered at a later date.

I authorize the investigation of any or all statements contained in this application. I also authorize, whether listed or not, any person, school, current employer, past employers, and organizations to provide relevant information and opinions that may be useful in making a hiring decision. I release such persons and organizations from any legal liability in making such statements.

I UNDERSTAND THAT THIS APPLICATION, VERBAL STATEMENTS BY MANAGEMENT, OR SUBSEQUENT EMPLOYMENT DOES NOT CREATE AN EXPRESS OR IMPLIED CONTRACT OF EMPLOYMENT NOR GUARANTEE EMPLOYMENT FOR ANY DEFINITE PERIOD OF TIME. ONLY THE PRESIDENT & CEO OF COMPANY HAS THE AUTHORITY TO ENTER INTO AN AGREEMENT OF EMPLOYMENT FOR ANY SPECIFIED PERIOD AND SUCH AGREEMENT MUST BE IN WRITING, SIGNED BY THE PRESIDENT & CEO AND THE EMPLOYEE. IF EMPLOYED, I UNDERSTAND THAT I HAVE BEEN HIRED AT THE WILL OF THE EMPLOYER AND MY EMPLOYMENT MAY BE TERMINATED AT ANY TIME, WITH OR WITHOUT REASON AND WITH OR WITHOUT NOTICE.
I have read and understand the above.  By submitting I give consent to these statements.