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PERSONAL INFORMATION

Name:*

Position(s) applied for:

Are you willing to work?

Street Address:

City:

State:

State

Primary Phone:*

Secondary Phone:

Email:*

Are you legally authorized to work in the United States?*

Yes
No

When could you start employment?

Have you previously applied for employment with JCL?*

Yes
No

Are you willing to undergo a background check and/or drug screening as required by company policy and applicable laws?*

Yes
No

EDUCATION

High School:

City:

State:

Year:

College or Vocational School:

City:

State:

Year:

Did you graduate?

Yes
No

Major:

Degree:

GPA:

Additional Training / Certificates:

Software in which you are proficient:

REFERENCES

Please list any references other than Supervisors.

Name of Reference:

Phone Number:

Years Known:

Relationship to Applicant:

Name of Reference:

Phone Number:

Years Known:

Relationship to Applicant:

WORK HISTORY

Employment History (starting with most recent)

Present or Last Position:

Dates Employed:

Company Name:

Company Address:

Job Responsibilities:

Starting Wage / Salary:

Final Wage / Salary:

May we contact your supervisor

Yes
No

Name of Supervisor:

Title of Supervisor:

Phone Number of Supervisor:

2nd Most Recent Job

Position:

Dates Employed:

Company Name:

Company Address:

Job Responsibilities:

Starting Wage / Salary:

Final Wage / Salary:

May we contact your supervisor

Yes
No

Name of Supervisor:

Title of Supervisor:

Phone Number of Supervisor:

3rd Most Recent Job

Position:

Dates Employed:

Company Name:

Company Address:

Job Responsibilities:

Starting Wage / Salary:

Final Wage / Salary:

May we contact your supervisor

Yes
No

Name of Supervisor:

Title of Supervisor:

Phone Number of Supervisor:

4th Most Recent Job

Position:

Dates Employed:

Company Name:

Company Address:

Job Responsibilities:

Starting Wage / Salary:

Final Wage / Salary:

May we contact your supervisor

Yes
No

Name of Supervisor:

Title of Supervisor:

Phone Number of Supervisor:

TERMS & CONDITIONS

PLEASE READ CAREFULLY: I understand that submission of this application does not guarantee employment and that any offer of employment is contingent upon the successful completion of pre-employment screening, including background checks and drug testing, where permitted by law. If hired, I agree to comply with all company policies and procedures. I understand that employment with JCL Service Company LLC and its subsidiaries is at-will, meaning that either the company or I may terminate the employment relationship at any time, with or without cause or notice, unless otherwise required by law. I certify that the information provided in this application is true and complete to the best of my knowledge. I understand that any false statements or omissions may result in disqualification or termination of employment. I authorize JCL Service Company LLC and its subsidiaries to verify the accuracy of the information provided, including contacting previous employers, educational institutions, and references. I release the company and all parties providing information from any liability that may result from such inquiries, in accordance with applicable laws. I understand that, if hired, I must provide satisfactory proof of identity and legal authorization to work in the United States within three days of employment. Failure to do so may result in termination. I acknowledge that I have read, understand, and agree to the above statements.*

Check this box to confirm understanding of the Terms & Conditions

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Passionate. Committed. Professional. Fun. Sound Like You?

PERSONAL INFORMATION

EDUCATION

REFERENCES

WORK HISTORY

2nd Most Recent Job

3rd Most Recent Job

4th Most Recent Job

TERMS & CONDITIONS