Apply HereIf you are looking to gain employment with UpLIFTD, please fill out the application below and we will be in touch. Which position are you applying for? Janitorial Lawn Other Name * First Name Last Name Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Phone * (###) ### #### Last 4 of Social Security Number * Valid Driver's License? * Yes No Email Date of Birth * MM DD YYYY Date available to begin work * MM DD YYYY Desired Salary * $ Are you a US citizen? * Yes No Are you legally eligible for employment in the United States? * Yes No Gender * Female Male Non-Binary Prefer not to answer Ethnicity * Native American Indian or Alaska Native Asian Black or African American Native Hawaiian or Pacific Islander Caucasian Other Prefer not to answer Were you referred by someone? Yes No If yes, who? Have you EVER been employed by this company? * Yes No If yes, when? Have you ever served in the US Military? Yes No If yes, what branch, dates, and type of discharge. Education: High School * Years attended? Did you recive a diploma? yes no GED College or Technical Training Institute Years attended? Did you recieve a degree? Yes No Any other relevant training or certifcations? Work History: Most Recent First Company: City and State Job Title Start Date MM DD YYYY End Date MM DD YYYY Job Duties Pay Rate: $ Reason for Leaving: Company: City and State: Job Title Start Date MM DD YYYY End Date MM DD YYYY Job Duties Pay Rate: $ Reason for Leaving: Company: City and State Job Title Start Date MM DD YYYY End Date MM DD YYYY Job Duties Pay Rate $ Reason for Leaving: Disclaimer I certify that my answers are true and complete to the best of my knowledge. I understand that if this application leads to employment, and false or misleading information may result in immediate termination. I AGREE Thank you!
