First Name*

Last Name*

Address

City

State

Zip

Home Phone

Cell Phone

Your Email*

Are you over 18 years old?*
yesno

Are you able to work in the U.S.?*
yesno

Do you have any health conditions that may affect your ability to perform your job?*
yesno

If yes, please explain:

Are you able to lift heavy objects?*
yesno

Are there any reasons that you cannot be in confined areas? (ONLY Tech and Repair applicants need answer)
yesno

If yes, please explain:

Are you willing to work overtime, if required?*
yesno

Have you ever been convicted of a felony?* (Conviction will not necessarily disqualify an applicant for employment.)
yesno

If yes, please describe conditions:

Have you received any tickets or have any pending charges in the past 6 months?*
yesno

If yes, please explain:

Do you have transportation to and from work?*
yesno

Can you provide a current copy of your driving record?*
yesno

EDUCATION

(Enter high school, college, and other training information. Include school name, location, year graduated, major, and diploma/degree)*:

WORK HISTORY

Most Recent Employer (Enter address, phone, date started/left, salary start/end, name/title of supervisor, description of duties, and reason for leaving)*:

Previous Employer 1 (Enter address, phone, date started/left, salary start/end, name/title of supervisor, description of duties, and reason for leaving)*:

Previous Employer 2 (Enter address, phone, date started/left, salary start/end, name/title of supervisor, description of duties, and reason for leaving)*:

In addition to your work history, what other experiences, skills, or qualifications do you have that would make you a good fit for our company?*

Positions applied for?*

Wage or salary desired?*

When can you start?*

How did you hear about Priority Pest Services?*

REFERENCES

Please list three references that are of no family relation to you (name and phone)*:

COVER LETTER / FILE ATTACHMENT (1 MB LIMIT) (OPTIONAL)

APPLICANT'S CERTIFICATION AND AGREEMENT
I certify that the facts set forth in the Application for Employment are true and complete to the best of my knowledge. I understand that if I am employed, false statements, omissions or misrepresentations may result in my dismissal. I authorize the company to make an investigation of any of the facts set forth in this application.

I understand that the employer may give me a conditional job offer, following which I may be required to furnish information regarding medical condition and history and any information regarding any pre-existing permanent physical impairment. I further understand that once given a conditional job offer, I may be required to submit to pre-employment testing for the illegal use of drugs.

Click the checkbox to agree to the above certification and agreement?

Note: You must agree to the above by clicking the checkbox, or you will not be able to successfully submit your application.*

Answer this correctly, to make sure you are human and not a termite, cockroach, ant, spider, bed bug, rat, mouse, mole or other unwanted non-human pest: 2+3?

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