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Applicant Information
Full Name
First Middle Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Email
Date Available:
MM slash DD slash YYYY
Social Security Number
Desired Salary
Position Applied For
Are you a citizen of the United States?
- Yes
- No
If no, are you authorized to work in the U.S.?
- Yes
- No
Have you every worked for Avon Cleaners?
- Yes
- No
If yes, when?
Have you every been convicted of a felony?
- Yes
- No
If yes, explain.

Education
High School
High School Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
When did you start high school?
MM slash DD slash YYYY
When did you leave high school?
MM slash DD slash YYYY
Did you get a graduate?
- Yes
- No
Did you get a diploma?
Higher Education
College
Address of your college
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
When did you start college?
MM slash DD slash YYYY
When did you leave college?
MM slash DD slash YYYY
Did you graduate college?
- Yes
- No
If yes, what is your degree?
Continued Education
Other Education
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
When did you start?
MM slash DD slash YYYY
When did you leave?
MM slash DD slash YYYY
Did you graduate?
- Yes
- No
If yes, what degree?

References
Please list professional references.
Name
First Last
Relationship
Company
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Additional Reference
Name
First Last
Relationship
Company
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
References Cont.
Name
First Last
Relationship
Company
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone

Previous Employment
Company
Phone
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Supervisor Name
First Last
Job Title
Starting Salary
Ending Salary
Job Responsibilities
Date Started
MM slash DD slash YYYY
Date Ended
MM slash DD slash YYYY
Reason for Leaving
May we contact your supervisor for reference?
- Yes
- No
Additional Employment
Company
Phone
Supervisor Name
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Job Title
Starting Salary
Ending Salary
Job Responsibilities
Date Started
MM slash DD slash YYYY
Date Ended
MM slash DD slash YYYY
Reasons for Leaving
May we contact your supervisor for reference?
- Yes
- No
Employment Cont.
Company
Phone
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Supervisor Name
First Last
Job Title
Starting Salary
Ending Salary
Job Responsibilities
Date Started
MM slash DD slash YYYY
Date Ended
MM slash DD slash YYYY
Reason for Leaving
May we contact your supervisor for references?
- Yes
- No

Military Service
Branch
Start Date
MM slash DD slash YYYY
End Date
MM slash DD slash YYYY
Rank at Discharge
Type of Discharge
If other than honorable, explain:

Disclaimer and Signature
I certify that my answers are true and complete to the best of my knowledge.
Consent*
I agree to the honesty policy.
I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.
Your Full Name*

Type your full name to submit your electronic signature.

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4347 Lovers Lane, DTX 75225

6301 Hillcrest Ave, Dallas, TX 75205