585 Conklin Rd, Binghamton NY 13903 | service@burkepestcontrol.com
 
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Application


 
APPLICATION FOR EMPLOYMENT
Burke Pest Control, Inc. is an equal opportunity employer. We do not discriminate regardless of age, religion, sex, national origin, marital status, presence of a non-job-related medical condition or handicap, etc. We are an “at will” employer.
We are a Drug Free Workplace.
 
 
 
 
 
 
 
Eligible for employment in the US?
 
At least 18 years of age?
 
 
Are you applying for:
 
 
 
 
Currently employed?
 
May we contact present employer?
 
 
 
 
 
Are you available for overtime?
 
Weekend work?
 
 
Do you have a valid drivers license?
 
What state?
 
 
Have you ever been convicted of a misdemeanor or felony?
(Conviction will not necessarily disqualify applicant from employment)
 
Veteran of US Military service?
 
Branch
 
EMPLOYMENT EXPERIENCE
List your past three (3) employers, starting with the most recent
 
Employer’s Name & Address
 
Start/Final Date
 
Supervisor Name
Rate of Pay
 
Reason For Leaving
 
EDUCATION
 
School Name & Address
 
Years Attended
 
Graduated
 
Course of Study
 
EDUCATION - List 3 references who are not related to you or previous employers
 
Name
 
Telephone No.
 
Occupation
 
Years Known
 
APPLICANT’S STATEMENT
I verify statements I have made in this application are correct and true.

I authorize investigation of all statements contained in this application for employment as necessary. I understand that this application is not a contract of employment and is not intended to be. Burke Pest Control, Inc. is an “at will” employer.

I understand this application will be active for a period of three months; after that time, if I wish to be considered for employment, I must submit a new application.

I understand, if hired, false or misleading information given in my application may result in dismissal.
 

Applicant’s Signature
 

Date