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Bloomington: 309-328-8312
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Name
First
Last
Primary Phone Number
*
111-222-3333
Secondary Phone Number
111-222-3333
Email
*
Date of Birth
*
MM slash DD slash YYYY
Address
*
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Afghanistan
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Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
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Aruba
Australia
Austria
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Cook Islands
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Eswatini
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Virgin Islands, U.S.
Wallis and Futuna
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Country
What position are you applying for?
*
Apartment Turn Kleener
Team Lead-Apartment Turn Kleener
Peoria Area Pro-Office Kleener
Creve Coeur Area Pro-Office Kleener
East Peoria Area Pro-Office Kleener
Bloomington Area Pro-Office Kleener
Springfield Area Pro-Office Kleener
Chillicothe Area Pro-Office Kleener
Washington Area Pro-Office Kleener
Team Lead-Office Kleener
Travelling Pro Kleener
Nightly Operations Manager
Human Resource Manager
Pekin Area Pro-Office Kleener
Do you have your own tools?
Yes
No
FEIN #
Do you carry Workers' Comp Insurance?
Yes
No
Do you have any snow customers of your own?
Yes
No
Do you have equipment available for snow removal?
Yes
No
What equipment do you have available for snow removal?
If you are interested in being Sidewalk Worker, do you have a truck that can carry a snow blower and salt bags?
Yes
No
Not applying to be a sidewalk worker
In order to work for Pro Kleen you must supply a copy of your MVR (Motor Vehicle Record). Can you do this?
Yes
No
What programs do you have experience with?
Microsoft Word
Microsoft Excel
Microsoft Power Point
Microsoft Outlook
Microsoft Access
QuickBooks
Other
If you have experience with other software please specify.
Do you have a driver's license?
*
Yes
No
Have you ever been convicted of a felony?
*
Yes
No
The year you were released from Prison?
1960
1961
1962
1963
1964
1965
1966
1967
1968
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
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1982
1983
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1985
1986
1987
1988
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1990
1991
1992
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1994
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1996
1997
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2000
2001
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2009
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2019
If you have been convicted of a felony please explain.
Are you on probation now?
Yes
No
If you are on probation now please explain.
Are you able to pass a drug test?
*
Yes
No
Current Employer
Phone Number
Address
List Former Employers
*
Previous Employer name
Position
Street Address
City
State
Phone
Supervisor
Pay
Reason for Leaving
Please list last three employers
What is your highest level of education?
*
Some High School
Graduated High School/GED
Some College
Associate's Degree
Bachelor's Degree
Master's Degree
How did you find Pro Kleen?
Indeed
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Job Fair
Employee Reference
Other
If employee reference, who referred you to Pro Kleen? Or if other, please specify.
Agree to terms and conditions
*
As an applicant, and/or if I am employed by Pro Kleen I have read, understand, and specifically agree to abide by all of these rules and procedures at all times during my employment and/or association at Pro Kleen.
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