Please complete this application formSomeone from our team will get back to you in the next 24 hours. Where did you hear about us?*Date of application First Name*Middle Name*Last Name*Date of Birth* Social Security Number*Drivers License Number*State*AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificPlease list any other states where you have resided.Physical Address*Cell Phone*Alternate PhoneEmail Address* When are you available to start?* Applying for Full-Time or Part-Time work?*Select OneFull-TimePart-TimeDaytime Evening or Night Work?*DaytimeEveningNightHave you worked for DK's Dustbusters before? If yes, then when?*Do you have access to a vehicle?*YesNoEMPLOYMENT SECTION(Please list cleaning and non-cleaning experience)Employer NameEmployer AddressEmployer Phone NumberFrom Date To Date Supervisors NameSupervisor's Phone NumberYou ResponsibilitiesReason for leavingSalaryEmployer NameEmployer AddressEmployer Phone NumberFrom Date To Date Supervisors NameSupervisor's Phone NumberYou ResponsibilitiesReason for leavingSalaryEmployer NameEmployer AddressEmployer Phone NumberFrom Date To Date Supervisors NameSupervisor's Phone NumberYou ResponsibilitiesSalaryReason for leavingEmployer NameEmployer AddressEmployer Phone NumberFrom Date To Date Supervisors NameSupervisor's Phone NumberYou ResponsibilitiesSalaryReason for leavingBackground InformationHave you ever been convicted of or pleaded "no contest" to a felony charge?*YesNoIf yes, please state the conviction, classification of the felony and the date of the conviction.Have you in the past ever been convicted of a crime other than a routine traffic violation, and are you currently the subject of any criminal action or investigation or on probation?YesNoReferencesPlease List 2 References (no family).Name*Phone Number*Years Known*Name*Phone Number*Years Known*EMERGENCY CONTACT INFOList 2 Emergency contact names and numbers.Emergency Contact Name*Number*Emergency Contact Name*Number*Section for Notes from applicant regarding application.*By Clicking on the "Submit" button below, you are electronically accepting this application as true and completed to the best of your knowledge. I, the undersigned, have voluntarily and knowingly provided information contained in this employment application. I certify that each question has been carefully considered and the information provided herein is true and correct. Moreover, I will notify DK's Dustbusters, Inc. immediately in writing of any material change to the information contained in this application. I hereby authorize DK's Dustbusters to conduct a personal and criminal background check in any state, which may include contacting previous employers, and references. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release. By signing this application, I also agree to a drug screening/urinalysis, if requested, at the time of hire and any other time during my employment at DK's Dustbusters, Inc.Full Name*Date of application This iframe contains the logic required to handle AJAX powered Gravity Forms.