Employee Application

First Name
M.I
Last Name

Address
City
Zip
Phone

In Case of Accident Nofity-Name
Relationship

Address
City
Zip
Phone

Own Your Home?Rent?Room and boards?Live and parents?MaleFemaleSingleMarriedDivorcedNumber of Dependents

Height
Weight
Age
Color of Hair
Color of Eyes

Place of Birth

Owner of a Car?
YesNoIf so, state Make
Year
Type of Licence
OperatorField RepApplicator

Have you ever been officially charged with a crime (except traffic violations)?

YesNoIf So What

Have you ever been convicted of a crime (except traffic violations)?

YesNoIf So What

Have you ever been a member of a Building Service Union?

YesNoWhen

Presently Employed?YesNoPlace of Employment

Present Working Hours - FromToPosition Held

Length of time in CaliforniaWhere from previously

Work Experience

1.From
To
Name and Address of Employer

Position
Hourly Rate
Reason for Leaving

2.From
To
Name and Address of Employer

Position
Hourly Rate
Reason for Leaving

3.From
To
Name and Address of Employer

Position
Hourly Rate
Reason for Leaving

4.From
To
Name and Address of Employer

Position
Hourly Rate
Reason for Leaving

5.From
To
Name and Address of Employer

Position
Hourly Rate
Reason for Leaving

Personal References
List three persons (not related to you) whom you have known for three years whom we can refer as to your character and habits

1.Name
Address
Occupation

2.Name
Address
Occupation

3.Name
Address
Occupation

Email Address

I certify that all of the above statements are true and correct. I hereby authorize Guarantee Pest Control and/or bonding representatives to make any investigations necessary to confirm these statements.

Bold = Required Field

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