Cleaners Coop Employee Application

Co-operative Cleaners of Ontario Inc.

Employee Application Form
Title (Mr/Mrs/Ms/Miss)*
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Email Address:*
example@example.com
Home Telephone:*
Cell Number:*
Date of Birth:

MonthDayYear
Date
Are you Bondable?

YesNo
Years of Experience:*
Position / Availability:
Position Applied For:*
Days Available

MondayTuesdayWednesdayThursdayFridaySaturdaySunday
Hours Available from:

:HourAM/PM Option
to
until :HourAM/PM Option
What date are you available to start work?

MonthDayYear
Date
Education Level

High School, etc.
Diploma / Degree:
Completion Date:

MonthDayYear
Date
List your Skills and Qualifications: Licenses, Training, etc.
Do you have a current WHMIS Certificate?

YesNo
Are you able to lift an average of 50lbs?

YesNo
Are you comfortable with Heights/climbing ladders?

YesNo
Depending on the contract, the scope of work may take you on the outside of the facility. Would you have a problem in winter/summer months?

YesNo
In previous positions, have you ever used the following equipment? (please check the items if yes)

Mop/Janitorial BucketCarpet CleanerPressure WasherVacuumAll Purpose Floor Cleaning Machine
Do you have access to the following items? (please check the items if yes)

Safety BootsHard Hat
Do you own a vehicle?

YesNo
Do you have a valid drivers licence?

YesNo
Employment History:
Please provide an updated resume:

Browse Files

Cancelof
Reason for Leaving your last job:
Please supply 3 reference including a job related reference (Name, title, & telephone number )
I certify that information contained in this application is true and complete. I understand that false information may be grounds for termination of employment at any point in the future if I am hired. I authorize the verification of any or all information listed above.
Signature:

Clear
Date:

MonthDayYear
Date
Should be Empty:

Co-operative Cleaners of Ontario Inc.

Position / Availability:

Education Level

Employment History: