Job Application Form


U.S. Citizen?
Have you ever applied before?
If Yes, when?
Are you legally eligible to work in the US?
Are you 18 years of age or older?
Have you ever been convicted of a crime (other than minor traffic violation)?
If Yes, please explain:
Driver’s License?
If Yes:
Will you pass a CORI check?

Employment Desired

Areas of Experience
Miscellaneous Expertise
Spoken Languages
Proficiency in Computer Applications
Are You Employed Now?
If So, May We Inquire Of Your Present Employer?
List all employment beginning with your most recent employer. If working through an agency, please indicate the company name as well as the agency.

Employment History

Company 1
Company 2
Company 3


May we conduct a background check of your qualifications, character and record of employment?
If No, please explain:
If Yes, I release Mass Junk Inc. any former employers, and all references listed above from any and all claims, demands or liabilities arising out of or related to such investigation or disclosure.
I certify that the information provided above (and accompanied resume, if any) is true and complete to the best of my knowledge as of the date hereof. I understand that any false statement, omission or misrepresentation on this application is sufficient cause for refusal to hire, or dismissal if I have been employed no matter when discovered by Mass Junk Inc.
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Mass Junk Inc. is An Equal Opportunity Employer, dedicated to a policy of non-discrimination in employment on any basis including race, color, age, sex, religion, disability or national origin.