Date:

Personal Information:

Last Name

First Name  Middle Initial

Present Address - Street/Apt#

City State Zip

Phone Numbers -    Main #

      Message/Cell Phone #

Are you 18 years of age or older? Yes No

Are you legally eligible to work in the United States?      (GRBS will require verification of this upon hire) Yes    No

Position Applying For: (Check all that Apply)                 

Custodial    Floor Care    Window Cleaning Supervision Management                       Administration

Check Locations Available in: (Check all that Apply)

Grand Rapids    Big Rapids    Detroit        Holland            Jackson            Kalamazoo    Lakeshore   Lansing         Petoskey          Traverse CityChicago       Cincinnati    Northern Indiana           

Other

How did you hear about us?                 Please Select One Employee Referral Word of Mouth News Paper Internet BillBoard Yellow Pages

Check Days you are available to work -

Monday    Tuesday     Wednesday      Thursday Friday      Saturday    Sunday

Please select one:  Part Time Full Time Call In (As Needed)

Maximum numbers of hours per shift

Hours of availability to work?

When would you be able to start?

What is your desired starting wage?

Have you ever been employed by Grand Rapids Building Services? Yes    No   

If yes, When and Where did you work for us? What name did you use when employed by GRBS? What was you reason for leaving?

Do you have experience with any of the following?     Window Cleaning    Floor Care        Carpet Cleaning        Supervision            Inspecting        Training                            If so, Please Explain in Detail 

Have you ever been convicted of a felony or misdemeanor? Yes    No

Are there any criminal charges currently pending? (Please note, prior criminal convictions do not necessarily mean you will not be hired)                                                          Yes No

Employment History                                                       (Please start with the most recent or current employer)

Name of Employer      May We Contact this Employer? Yes    No                       

Address                     City State Zip     Telephone Number                                Name of Supervisor    

Beginning Date      End Date     Position Held   Wage            Reason for Leaving ?

Name of Employer      May We Contact this Employer? Yes    No                       

Address                     City State Zip     Telephone Number                                Name of Supervisor    

Beginning Date      End Date     Position Held   Wage            Reason for Leaving ?

Name of Employer  

May We Contact this Employer? Yes    No                       

Address                     City State Zip     Telephone Number                                Name of Supervisor    

Beginning Date      End Date     Position Held   Wage            Reason for Leaving ?

By Submitting this application, I attest that all information is accurate and complete to the best of my knowledge. I understand that this information will be kept confidential and used only for employment purposes with Building Services. I understand that falsification of information will result in rejection of this application or termination after hire.