Arizona Pest Control Online Employment Application

Notice to applicants.
Federal and state law requires that all applications be considered without regard to race, religion, color, sex, age or national origin. We believe in and fully support the principle of equal employment opportunities and will fulfill our obligations to the fullest.

Name
Current address	Phone Number
Position Applied for	Referred by Newspaper Friend Other
Salary desired	Spanish speaking Y N
Please enter your email address:

Employment Desired

Are you employed? Y N

If yes can we contact your present employer?
Y N

Date you can start

Are you currently certified by the SPCC

Y N
If yes what is your number

Do you have any experience in this industry?
Y N

Former employers (List last four employers, starting with last one first)

Date from/to	Name/Address employer	Salary	Position	Reason for leaving

References:
Give below the names of three persons not related to you
whom you have known at least one year.

Name	Address	Phone	Years known

Education Section

Name and location of School	City	Years Attended	Did you graduate	Majors
Elem.			Y N
High			Y N
College			Y N
Trade			Y N

General Education/training
Subjects of special study/research work or special training skills

US Military or Naval Service

Rank:

AUTHORIZATION

"I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that if employed, falsified statements on this application shall be grounds for dismissal. I authorize investigation of all statements contained herein and references and employers listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release the company from all liability for any damage that may result from utilization of such information. I also understand and agree that no representative of the company has any authority to enter into any agreement for employment for any specified period of time, or to make any agreements contrary to the foregoing, unless it is in writing and signed by an authorized company representative."

Submitting this form serves as my authorization to any former employer, individual, law enforcement agency, school, doctor, the military service, credit reporting bureau, or any public or private agency or company to provide information about me for purpose of determining my suitability for employment. I agree that none of the above shall be liable in any respect for proving requested information.

By submitting this form and using the "submit my signature" button,
you are agreeing to this form as if you had signed it yourself.

Initial here to agree.