Apply – CleanTech Environmental Inc.

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Preliminary Employment Application

TO BE READ AND SIGNED BY APPLICANT

I understand that information I provide regarding current and /or previous employers may be used, and those employer(s) will be contacted, for the purpose of investigating my safety performance history and required by 49 CFR 391.23(d) and (e). I understand I have read the right to:

Review information provided previous employers;

Have errors in the information corrected by previous employers and for those previous employers to re-send the corrected information to the prospective employer.

Have a rebuttal statement attached to the alleged erroneous information, if the previous employer(s) and I cannot agree on the accuracy of the information.

Signature

Clear Signature

Date

APPLICANT TO COMPLETE

Please select the area's of business you are interested in applying for.

Name

First

Last

Phone

Current Address

Address Line 1

Address Line 2

City

State

Zip Code

How long have you lived at current address?

Year / Month.

Previous Address

Address Line 1

Address Line 2

City

State

Zip Code

How long did you live at your previous address?

Year / Month.

Do you have the legal right to work in the United States?

Yes / No

Can you provide proof of age?

Yes / No

Date of Birth

Required for Commercial Drivers.

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In compliance with Federal and State equal employment opportunity laws, qualified applicants are considered for all positions with out regard to race, color, religion, sex, national origin, age, marital status, veteran status, non-job related disability, or any other protected group status.