Employment Application

If you want to apply for a job with CLM Services, please complete the following application. Once completed, pressing the SUBMIT button will send this application to CLM Services and forwarded to the applicable manager.

To help us consider your application, please complete all applicable questions.

An application MUST be filled out for EACH applicant. If couples wish to apply together, please complete an application for EACH of you.

Base Data

Personal Information

Your full name* Email address* Street adress* City, State and Zip* Telephone # (Day)* Telephone # (Night)*

Position Information

Position(s) desired* Supervisor Options Supervisory Non-Supervisory Desired location 1 Desired location 2 Desired location 3

Additional Information

Applicant Information

Are you at least 18 years old? Yes No WIll you accept part-time employment? Yes No WIll you accept seasonal employment? Yes No If yes, from:

to:

Have you ever applied for employment with us before? Yes No If yes, what month and year:

Do you hold a valid Security Guard Registration Card? Yes No If yes, expiration

If yes, card number and state Select all valid First Aid and/or emergency care certificates you currently hold:

Additional Information

Are you able to perform the essential tasks and duties of the position you are applying for with or without reasonable accommodation?* Yes No If no, please describe the duties and tasks that cannot be performed.

Employment Application Continued - Page 2

Education

High School

High School attended

Location

Dates attended

Number of years

High school graduate? Yes No

College

College attended

Location

Dates attended

Number of years

Graduate? Yes No

Vocartional / Technical

Vocational and Technical schools attended

Location

Dates attended

Number of years

Graduate? Yes No

Employment History

Previous Employment

Name and address of employer

Employment dates

Reason for leaving

Employer 2

Name and address of employment

Employment dates

Reason for leaving

Employer 3

Name and address of employment

Employment dates

Reason for leaving

Employer 4

Name and address of employment

Employment dates

Reason for leaving

Employment Application Continued - Page 3

Business and Personal References

Reference

Name and address

Phone number

Occupation

Relationship

Reference

Name and address

Phone number

Occupation

Relationship

Reference

Name and address

Phone number

Occupation

Relationship

Reference

Name and address

Phone number

Occupation

Relationship

Supplemental Information

Do you have a late model RV, or Travel Trailer? If so, please describe. If not, how are you planning to maintain a residence?

Are you limited in the hours you can work? If yes, please explain.

What interests you in this type of work?

A significant part of your job will include cleaning toilets? Do you any objections to performing that type of work?

What are your interests in working with the public?

Please list any additional information which will help us assess your qualifications.

Please attach a photo of yourself and your RV. Be sure the graphics have been reduced to less than 800x600 pixels ion size.

Photo Upload

Drivers License

Many employees are required to drive as part of their duties. Please enter your drivers license #

State license issued from

Drivers license expiration date

Certification

Confirm that all information entered is true with your initials:

Security

Employment Application Received

Thank you for submitting your employment application with CLM Services.

We'll review your application and get in contact with you soon.

If you wish to followup on your application, please send an email: info@clm-services.com

	CLM Services Corporation 675 Gilman Street Palo Alto, CA 94301, USA
	Tel: (650) 322-1181
	Fax: (650) 322-1194
	or email us at: info@clm-services.com