Housekeeping and Custodian Experience

tonya hoberty’s Employment Application

Application Date: 9/13/2026

Job Title: Housekeeping/Custodian

Job Location: Springfield

Personal Information

First Name: tonya

Last Name: hoberty

Email: ****************@*****.***

Contact Information

Cell Phone: +1-937-***-****

Address: 844 E. Cecil St

City: Springfield

State: OH

Postal Code: 45503

Application Questions

Please list other names used: same

If you were referred by an employee, please list who referred you to MHS: none Do you have relatives currently working for MHS? If yes, please list. If no, write N/A: N/A Are you over 18 years of age: Yes

Please indicate all you are applying for: Full-Time (35+ hours per week) Please indicate which department(s) you are interested in. You may choose more than 1. Adult Outpatient-Clark County, Adult Outpatient-Madison

Desired Compensation: SEK1,600 hourly

Have you previously worked for MHS? No

Previous dates of employment: N/A

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1. Employment History (Most recent first):

Job Title: Housekeeper

Employer Name: Executive Management

City: Springfield

State or Province: OH

Currently Employed? No

Start Date: 09/04/2025

End Date: 09/10/2026

Job Duties/Responsibilities: Emptying Trash and dushing, vacuming and cleaning tables.moping fioores. Reason for leaving: Know Insurance

2. Employment History

Job Title: Deil Worker

Employer Name: Walmart

City: Springfield

State or Province: OH

Currently Employed? No

Start Date: 03/21/2018

End Date: 02/12/2024

Job Duties/Responsibilities: Cleaning and Cooking,Stocking,Helping Custores. Reason for leaving: IGot Hurt Bad and Brock arm

3. Employment History

Job Title: Deil Worker

Employer Name: Kroger

City: Springfield

State or Province: OH

Currently Employed? No

Start Date: 04/15/2006

End Date: 02/06/2018

Job Duties/Responsibilities: Cleanig,Cooking and Stocking. Reason for leaving: n/a

Education-High School/GED

School Name: Nothwester HIGH

City: Springfield

State or Province: OH

Currently Attend? No

Start Date: 08/23/1982

End Date: 06/04/1985

Did you graduate? Yes

Education-College/University

School Name: N/A

City: Springfield

State or Province: OH

Currently Attend? No

Start Date: n/a

End Date: n/a

Degree : n/a

Area of Study: N/A

Did you graduate: No

Education-Graduate

School Name: n/a

City: Springfield

State or Province: OH

Currently Attend? No

Start Date: 02/04/1966

End Date: 02/05/1966

Degree: n/a

Area of Study: N/A

Did you graduate? No

Additional Information

Please list any additional relevant experience, skills, education or training, including expiration date if any : Floor buffing

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Please select the license/certification you hold. If yours is not listed, please select other and indicate below: Other (List Below)

Please enter your license/certification number and expiration date: Barbar license cerificationn/a If your license/certification is not listed, please list below with dates of expiration and issuing board/state: n/a

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Have you ever been convicted of a crime, either misdemeanor or felony (other than a minor traffic violation)? Answering YES does not exclude you from employment. All MHS offers are contingent upon an OHIO BCI/FBI (as required) background check prior to employment. : No If YES, please enter the offense and date of conviction below. This is Required. : n/a Please list 3 PROFESSIONAL references. References may not be related to you. 1. Reference: Holly Nola

Phone Number (Required): 937-***-****

E-Mail (Required): n/a

2. Reference : Tamra Foster

Phone Number (Required): 937-***-****

E-Mail (Required): n/a

3. Reference : Stephanie Carnes

Phone Number (Required): 937-***-****

E-Mail (Required): n/a

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I certify that the information provided in this application is accurate and without any consequential omissions of any kind whatsoever. I understand that if I am employed, any false, misleading or otherwise incorrect statements made on this application or during the pre-employment process may be grounds for my immediate termination.I give Mental Health Services (MHS) authority to contact all references and employers listed, and understand that all offers of employment are contingent upon references, all required federal and state background checks

(including Ohio BCI/FBI), and successful completion of a medical exam, including drug screen.This application and acceptance does not constitute an employment contract, and I understand that MHS or I may terminate an employment relationship at any time.I agree to hold in strict confidence any information obtained in the application or pre-employment process regarding Mental Health Services employees and clients. Acceptance: Yes

By checking this box, you acknowledge and consent to terms of the privacy policy which applies to the applicant tracking service being offered by Paycor on behalf of Mental Health Services for Clark & Madison Counties. The privacy policy offers an explanation of how and why your data will be collected, how it will be used and disclosed, how it will be retained and secured, and what legal rights are associated with that data (including the rights of access, correction, and deletion). The policy also describes legal and contractual limitations on these rights. The specific rights and obligations of individuals living and working in different areas may vary by jurisdiction. I have read and agree to this statement

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