Please complete the following Employment Application form and we will contact you regarding Employment Opportunities at Boston Cleaners. If you prefer, please print and fax to (951) 509-6934. Boston Cleaners On-Line Employment Application General Information Your Full Name: Your Email Address: Home Address: City: State: Zip Code: Phone - Day: Phone - Night: Social Security Number: Job Desired: Location(s) Desired: (Click here to view locations) What days and hours for work do you prefer?: Date available to start working: If you are not a US citizen, do you have an entry permit allowing you to work?  Yes No Type of employment desired:  Full-Time Part-Time Summer/Temporary How did you hear about the jobs offered at Boston Cleaners? Walk-in       Classified Ads       Referral       Website   Other: Did you work at Boston Cleaners before? Yes     No      When?    What position did you hold?    Which location did you work at? Employment History Note: Please list your current or most recent job first, include military service, and be as complete as possible.  Thank you. Current or Most Recent Job: Dates worked (Include both month and year): Employer's name: Employer's location: Name of supervisor: Your job title: Describe your job duties:                 Ending Salary: Per Hour or Per Week Are you still Employed?   Yes     No    If yes, why do want to leave? If No, why did you leave? May we contact this employer? Yes     No   Next last job: Dates worked (Include both month and year): Employer's name: Employer's location: Name of supervisor: Your job title: Describe your job duties: Ending Salary: Per Hour or Per Week Why did you leave? Did you work under another name? Yes     No        If so, what name? May we contact this employer? Yes     No   Next last job: Dates worked (Include both month and year): Employer's name: Employer's location: Name of supervisor:  Your job title: Describe your job duties:                 Ending Salary: Per Hour or Per Week Why did you leave? Did you work under another name? Yes     No        If so, what name? May we contact this employer? Yes     No   Education and Training High School High School name and location of school: Number of  years completed: Did you graduate High School?    No   Yes (Diploma)     Yes (G.E.D.) What was your high school course of study?: Technical / Vocational School Technical / Vocational School name and location: Number of years completed: Did you graduate from this Technical / Vocational School?    No     Yes What was your Major or course of study at this Technical / Vocational School?: College / University College / University name and location: Number of years completed: Did you graduate from this College / University?    No     Yes What was your Major or course of study at this College / University?: Other Describe other training and hobbies or interests which you feel may help you in the job you seek:    Do you have any physical handicap or chronic illness which would restrict you in doing the job you seek?     Yes   No If yes, please describe: Have you been convicted of any violations of law other than minor traffic violations?     Yes   No If yes, please describe: (A criminal record does not automatically bar employment) References Please list three professional references: 1.  Name: Job Title: Address: Phone: 2. Name: Job Title: Address: Phone: 3. Name: Job Title: Address: Phone: Miscellaneous Write here any statement you wish to make to further support your application:                  READ THE FOLLOWING PARAGRAPH CAREFULLY By submitting this application, I hereby certify that the statements made are true to the best of my knowledge.  I understand that any willful misrepresentation of essential facts may be reason for dismissal.  I hereby give my permission to Boston Cleaners to verify this information.  I release Boston Cleaners and all contacted persons from all liability that may issue from such verification and/or amplification process. I accept these terms.