Craig Thomas Pest Control, Inc.

Tell Us About Yourself

You must answer EVERY question on this application. If a question does not apply, put "N/A."

What positon are you applying for?
What is your salary expectation?	$
When can you start work? (Date)
How were you referred to us?
Have you completed an application here before?	YesNo
If yes, date/location
Have you been employed here before?	YesNo
If yes, date/position/location
Are you available to work (Check any that apply):
Full-time Part-time Temporary Nights Weekends
Are there any days or times during the week that you are not available to work? (Reasonable accommodation of religious needs that do not create an undue hardship will be considered, if applicable) YesNo
If yes, please list the days/times you are not available to work

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If necessary, can you provide proof that you are over any minimum work age requirement?	YesNo
Are you wiling to work overtime?	YesNo
Do you have steady transportation to work?	YesNo
Can you travel, if required?	YesNo
What percentage of time?
Are you on layoff and subject to recall?	YesNo
May we contact your present employer?	YesNo
How much time have you lost from work during the past 12 months?
Are you now, or do you expect to be, engaged in any other business or employment while working here?	YesNo
If yes, please explain
Are you presently an officer, employee, or employer of another business in our industry or with whom we compete?	YesNo
If yes, please explain
Have you ever been terminated or asked to resign from a job?	YesNo
If yes, please explain
Have you ever been refused a bond?	YesNo
Why do you desire to make a change?
Are you legally eligible to work in the United States?	YesNo

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What three things are the most important to you in a job?

What three adjectives best describe you?

What type of work do you most enjoy?

Why do you want to work here?

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Tell Us About Your Special Skills and Qualifications

List any special skills, training, experience, certifications, or licenses that may be relevant to this position or our company

List any professional, trade, business, or civic activites or offices held that would relate to working here

List any foreign languages that you fluently speak, read, and/or write that would relate to working here

List any software programs that you are proficient in

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Schooling

High School or GED
Did you graduate?YesNo
Years Completed	Degree Recieved & Major Subject
Name of School	Location
Trade, Business or Correspondence
Did you graduate?YesNo
Years Completed	Degree Recieved & Major Subject
Name of School	Location
College
Did you graduate?YesNo
Years Completed	Degree Recieved & Major Subject
Name of School	Location
Graduate School
Did you graduate?YesNo
Years Completed	Degree Recieved & Major Subject
Name of School	Location

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Tell Us About Your Driving Record

Necessary for positions that may require use of a personal or company vehicle for work.

Do you hold a valid Driver's License? Yes No   If yes, provide the state

Have you been convicted of any moving violation(s) in the last 3 years? YesNo

If yes, give date(s) and explanation of each

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Tell Us About Your Past

Answering "yes" to any of these questions is not an automatic bar to employment.

Have you ever been disciplined or terminated from any job for an act of violence, harassment, discrimination, ethical breach or theft?
Yes No	If yes, explain the circumstances, employer, and date
Have you ever been a defendent in a civil action for an intentional tort? (eg. assault, battery, false imprisonment, infliction of emotional distress, tortuous interference with a business relationship, defamation, invasion of privacy, fraud and misrepresentation, abuse of process and malicious prosecution or others)
Yes No	If yes, provide an explanation of the nature of the intentional tort, the date of the action, the location, and the disposition or outcome
Do you currently have any criminal charges pending against you?
Yes No	If yes, describe the details of the charge(s), the date(s) of the offense(s) (month and year), your age at the time of the offense(s), and the current status of the charge(s)
Are you currently wanted by any law enforcement agency?
Yes No	If yes, by what agency and for what act?

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Tell Us About Any Records

(Must be answered by all candidates other than those in Massachusetts)

Have you ever been convicted of; received a sentence for; pled nolo contendere (no contest) to; been placed on probation, fined, or entered a pretrial intervention program for; or had adjudication withheld by any judicial or quasi-judicial body for a crime, other than a minor traffic violation? (Any criminal record not disclosed by you may be considered falsification of this application, which may result in revocation of your employment offer or termination of your employment. Also, in accordance with any state or federal regulations, you may be required to provide copies of any criminal records. Answering “yes” to this question is not an automatic bar to employment.)

YesNo

If yes*, describe the details of the conviction or other disposition of the charge, the date of the offense (month and year), your age at the time of the offense, and your rehabilitation since the conviction and/or disposition of the offense (See below for specific instructions related to your particular state. If your state is not listed, answer this question as worded.)

*Connecticut Candidates:
• Applicants do not have to disclose erased records of arrests, criminal charges, or convictions;·
• Applicants with erased criminal records can swear under oath that they have never been arrested; and
• Criminal records eligible for erasure include delinquency determinations, findings as a child in a family with service needs, youthful offender adjudications, dismissed or
nolled criminal charges, criminal charges where the accused was found not guilty or received an absolute pardon, and any other conviction where erasure is allowed by law.
*Michigan Candidates: For any misdemeanors, list only those that resulted in convictions.
*Nevada Candidates: List all felony convictions and any misdemeanor convictions that occurred in the past 10 years and that resulted in imprisonment.
*Rhode Island Candidates: List convictions only.
*Utah Candidates: For any convictions, list only felonies.
*Washington State Candidates: List any convictions or terms of imprisonment within the past 10 years only.

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Military Service

Branch of Service:

Rank at discharge, if applicable:

List duties and special training and/or skills

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Non-Compete Agreement

Are you currently subject to a Non-Compete Agreement or Restrictive Covenant that would prohibit you from working at our company in the position for which you are applying?

YesNo

If yes, provide a copy of the agreement and state the name of the company:

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Agreement and Release

For the purpose of this agreement and release, the organization that has provided you with this application is referred to as “the company,” “this company,” or “you.” The facts set forth above in my application for employment are true and complete. I understand that false statements or omission of information on this application (even if discovered after employment) or any other employment form may lead to dismissal or denial of employment. You are hereby authorized to make any investigation of my personal history, financial, criminal, credit, and motor vehicle records through any investigative or credit agencies or bureaus of your choice. You are also authorized to administer a personality profile or other pre-employment tests and verify my background. A criminal record or sentence is not an automatic disqualification for employment. I agree to submit to any drug or alcohol testing prior to or after employment, and I agree to submit to a medical evaluation, if required. I consent to the release of any or all medical information or records deemed necessary to determine my capability to perform the essential job functions of the position for which I may hold. In making this application for employment, I also understand that an investigative consumer report may be made whereby information is obtained through personal interviews with my neighbors, friends, or others with whom I am acquainted. In exchange for the consideration of my employment application by this company, I hereby release and forever discharge this company (including its directors, officers, employees, and agents) and my past and/or present employers (including their directors, officers, employees, and agents) from any liabilities which may result from an investigation of my past and/or present employment or from the disclosure of such information. I authorize the use of any information in this application to verify my statements, and I authorize past employers, doctors, all references, and any other persons to answer all questions asked concerning my ability, character, reputation, and previous employment record. I understand that if my application is accepted that employment with this company at all times is employment “at will.” It is further understood that this “at will” relationship may not be changed by any written document, verbal statements, or by conduct unless an authorized executive of this company specifically acknowledges such change. I further understand that my “at will” employment may be terminated at any time by this company or myself and includes no guarantee, contract, or promise of employment for any specific length of time. I understand that the first 90 days of employment is a new-hire introductory period.

I have read, understand, and consent to these statements. YesNo

Date:

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Emergency Contact

In case of emergency, I authorize you to contact:

Name: Phone Number: