Team Member Application

Personal Information

Name *

Address *

Phone *

Email *

Date of Birth *

Are you 18? *

Yes No

Have you ever been convicted of a felony? *

Yes No

Name *

Address

For which position are you applying? *

Salary Desired

Hours Available

Total Hours Per Week

Who Referred you to Aim High Coin Laundry? *

Have you ever worked for our company before?

Yes No

List three persons with whom you hve been acquainted with for at least one year.

Person #1 *

Are you currently employed? *

Yes No

Employer #1

Employer #2

Employer #3