Job Application Complete this application and we'll contact you. Camacho Equipment & Janitorial Supply, Inc. is an equal opportunity employer and participates in E-Verify. Application for employmentName* First Middle Last Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Date of Birth* Month Day Year Place of birth* (city and state)Phone number*Email* Job Location Applying For* please be specificAre you a United States citizen?* Yes No Are you authorized to work in the US?* Yes No Have you worked for us before* Yes No Dates MM slash DD slash YYYY Month/YearHave you ever been arrested for or convicted of a felony crime?* Yes No Please explain-MILITARY SERVICEHave you ever served in the US military?* Yes No Which branch were you in?Select oneArmyMarinesNavyAir ForceCoast GuardWhich rank class were you at discharge? Enlisted Warrant Officer Commissioned Officer Officer rank at dischargeSelect oneO10O9O8O7O6O5O4O3O2O1Warrant Officer rank at dischargeSelect oneW5W4W3W2W1Enlisted rank at dischargeSelect oneE9E8E7E6E5E4E3E2E1Dates Served: Month/Year to Month/YearType of dischargeHonorable DischargeGeneral discharge under honorable conditionGeneral discharge under other than honorable conditionDishonorable DischargeBad Conduct DischargeOfficer Dismissal/DischargeEntry Level Separation DischargePlease explain:EDUCATIONHigh School* Name and city of high schoolDid you graduate* Yes No No, and I have a GED College Name and city of collegeDid you graduate Yes No Highest degree level earnedPlease select oneDoctoralMasterBachelorAssociatePROFESSIONAL REFERENCEName* Relationship* Company worked for* Phone number*PERSONAL REFERENCEName* other than immediate familyRelationship Phone number*EMPLOYMENTBegin with current or last employer1. Company Name* May we contact this company for a reference?*YesNoAddress* Street Address City State / Province / Region ZIP / Postal Code Phone number*Dates Employed* Month/Year to Month/YearSupervisor Name* First Last Your Job Title and Responsibilities*Ending Salary/Wage Reason left this company* 2. Company Name* previous employerMay we contact this company for a reference?*YesNoAddress* Street Address City State / Province / Region ZIP / Postal Code Phone number*Dates Employed:* Month/Year to Month/YearSupervisor Name* First Last Your Job Title and Responsibilities*Ending Salary/Wage Reason left this company* Any comments you believe are relevant to your skills and qualifications:Disclaimer and SignatureI certify that my answers are true and complete to the best of my knowledge. If this application leads to an offer of employment or I am hired, I understand that false or misleading information in my application or interview may result in withdrawal of any employment offer and/or immediate termination of employment.Do you accept this disclaimer?* Yes No Selecting 'No' will result in application being rejected. Selecting 'Yes' will provide a "Submit" button to send your application to our company for review.Name* First Last Today's Date* MM slash DD slash YYYY Δ