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Employment Application

    rdenberg@bluroo.com

    Applied at Store

    Application Accepted by

    Colony Acquisition Corp.
    Application for Employment

    Colony Acquisition Corp. also known as Dry Cleaning Depot, and BluRoo, hereafter referred, as “The Company” is an equal opportunity employer that does not unlawfully discriminate with any employment practices. No question on the application is used for the purpose of limiting or excluding any applicant from consideration for employment on a basis prohibited by local, state, or federal law. Legal access to employment, services, and programs is available to all qualified persons. Those applicants requiring reasonable accommodation to complete the application and/or interview should notify the Company’s Human Resources Manager.

    Position(s) Applied for

    Type of employment desired

    Days Unavailable:

    Type of position desired

    Hours unavailable

    Salary Requirements

    Date available to start work

    Applicant Info

    Name:

    Address:

    City & State:

    Zip

    Contact Number:

    Alternate Contact Number:

    Name Changes

    Have you ever used, worked or attended school under another name?

    If so, what was that name?

    In what states did you use the other name?

    Personal Data:

    • Have you ever been previously employed by our Company?

    If yes, When

    What Position

    Location

    • How were you referred to us?

    • Are you legally authorized to work in the United States?
    (If hired, verification will be required consistent with federal law)

    • Are you under the age of 18?
    If under the age of 18, please state your age (the primary reason for this question is to address any child labor laws):

    • Do you have any relatives working in our Company?

    If yes, give Name, Relationship, Position & Location:

    • Have you ever been convicted of a criminal offense or entered a plea other than “not guilty” to any criminal charge?

    If yes, please state the offense(s), date(s) of conviction(s) and sentence(s) imposed or disposition(s).

    Note: Your responses will not automatically disqualify employment.

    •Have you ever been accused in an administrative (e.g. EEOC) or court claim of fraud, defamation, assault, battery, false imprisonment, invasion of privacy, discrimination, sexual harassment or any other intentional wrong?

    If so, please explain (include any information you deem appropriate, including the date of the claim, the present status of the matter, if the matter concluded the final disposition of the matter). An affirmative answer to this question does not automatically disqualify you from employment with the Company.

    • Drivers license number (if driving is an essential job duty):

    Skills & Qualifications Summary:

    Languages that you speak & write:

     

    Current Employer:

     

    I grant The Company permission to contact my current employer:

    Employment History:

    Please provide all employment information for your past three (3) employers starting with the most recent.

    Employer:

    Job Title:

    Address:

    Telephone #:

    Immediate supervisor & title:

    Dates employed: from

    to

    salary

    Job summary:

    Reason for leaving:

    Please provide all employment information for your past three (3) employers starting with the most recent.

    Employer:

    Job Title:

    Address:

    Telephone #:

    Immediate supervisor & title:

    Dates employed: from

    to

    salary

    Job summary:

    Reason for leaving:

    Please provide all employment information for your past three (3) employers starting with the most recent.

    Employer:

    Job Title:

    Address:

    Telephone #:

    Immediate supervisor & title:

    Dates employed: from

    to

    salary

    Job summary:

    Reason for leaving:

    Educational History:

     

    List school name and location, course of study, and any degrees earned:

    High School:

    Address:

    Course of Study:

    Degree Earned:

    Technical Training:

    Address:

    Course of Study:

    Degree Earned:

    College:

    Address:

    Course of Study:

    Degree Earned:

    Military History:

    Have you served in the U.S. Armed Services?

    What Branch of the Service?

    Date Entered:

    Date Discharged/Separated:

    Starting Rank:

    Rank at Discharge:

    Duties/Special Training:

    Citations earned:

    Have you ever been dishonorably discharged from the military? If so, please explain.

    Application Acknowledgement:

     

    Verification of Information

    I understand that any offer of employment or employment by the Company arising out of the application for employment will be subject to satisfactory verification of all job qualifications and information contained in this application for employment. Verification may include academic credentials, licenses, professional designations, criminal and military records review, credit and employment history.

     

    Pre-Employment Testing

    I understand, where permissible under applicable state, federal, and local law, I may be subject to a pre-employment drug test after receiving a conditional offer of employment, and must receive a negative result before being permitted to commence work with the Company. I also may be subject to post-employment drug tests: 1) post accident; 2) random; or 3) upon reasonable suspicion in accordance with applicable federal, state and local law.

    I understand, where permissible under applicable state, federal, and local law, I may be subject to a pre-employment medical examination after receiving a conditional offer of employment, and must meet the qualifications for the position, with or without reasonable accommodation, before being permitted to commence work with the company.

     

    Contact & Release of Employers, Schools & References

    I authorize the Company to contact any of my schools, former employer(s) or references. I authorize any former school(s), to furnish academic information to the Company and I authorize any former employer to furnish any employment information to the Company. I authorize each reference to furnish any information about me to the Company that is relevant to my application for employment. Furthermore, I release said school(s), employers and references, the Company and their agents, from all liability arising out of providing or obtaining such information.

     

    Confidentiality and Agreement

    I have been informed and understand that certain positions within the Company require me to sign a Confidentiality and Agreement (Agreement). I acknowledge and agree that if I am requested to sign such Agreement to either qualify for an offer of employment or to maintain employment if employed by The Company, that I will sign such agreement. I further understand that, if I refuse to sign such Agreement that an offer of employment may be voided and if I am employed, it may be cause for immediate dismissal.

     

    Employment Period

    I understand that employment with the Company is for no fixed period of time, meaning employment is at-will and may be terminated by the Company or myself at any time for any reason with or without prior notice. No oral representation to the contrary has been made to me, and I further understand that no employee of the Company, other than the President of the Company in writing signed by the President and me, is authorized to make any such representation now or in the future. I further understand that the Company may change the terms and conditions of employment at any time for any reason with or without prior notice.

     

    Application Material & Statements

    I understand that this application and any material accompanying it shall become the sole property of the Company.

     

    I certify, under penalty of perjury, that all of the above information is true and complete, and I understand any misleading or incorrect statement or omissions may render it void and be cause for refusal of employment, and if I am employed, be cause for immediate dismissal. I have disclosed all information that is relevant and should be considered applicable to my candidacy for employment.

     

    Jury Waiver Agreement

    Although the Company believes that our internal complaint resolution procedures should be sufficient to resolve any workplace problems that you may have, we recognize that sometimes, notwithstanding everyone’s best efforts, a matter cannot be resolved internally. In those rare instances, we believe that our nation’s judges (such as our federal judges who are appointed by Congress for life and thus are free from any outside bias or influence) are in the best position to resolve our workplace disputes. Accordingly, we have created this policy, which, in effect, says that if you file a lawsuit, our nation’s judges will decide if we acted correctly or incorrectly. This policy does not take away any of your rights to sue or seek any type of remedy the law allows, it simply provides for a federal or state judge to decide our differences. By signing this agreement you consent to waive your right to a jury trail with respect to any lawsuit you may commence against Colony Acquisition Corp., its affiliates, subsidiaries, divisions, successors, assigns, and purchasers, and the current, former, and future employees, shareholders, officers, directors, and agents thereof the Company, relating in any manner to your application for, employment with, or cessation of your employment, or any term or condition of your employment with the Company. Absent your signing this Jury Waiver Agreement you would not be hired and/or remain employed by the Company. You have the right to consult with counsel of your choosing regarding this Jury Waiver Agreement or to singing this document.

    By signing below you acknowledge that you have had a reasonable period of time to consider this Jury Waiver Agreement including waiving your right to a jury trail knowingly, voluntarily, and free from duress or coercion.

     

    Applicant Signature

    Date

    Drug Free Workplace and Equal Opportunity Employer