APPLICATION FOR EMPLOYMENT

Serenity Cleaning Professionals LLC is an equal opportunity employer. The company’s policy is not to discriminate against any applicant or employee based on race, sex, religion, national origin, age disability, or any other basis protected by applicable federal, state, or local laws. Serenity Cleaning Professionals also prohibits harassment of applicants or employees base on any of these protected categories. It is also Serenity Cleaning Professionals policy to comply with all applicable state and federal laws respecting consideration of unemployment status in making hiring decisions.

If you are under 18 and it is required, can you furnish a work permit? □ YES □ NO

Driver’s License Information: State:

BEFORE answering the following question, please read the state specific instructions below

if you reside in, or are applying for a position in, California, Connecticut, Georgia, Hawaii, Massachusetts, Michigan, Minnesota, Nebraska, Nevada, New York, Newark, N.J., Ohio, Pennsylvania or Washington.

**HAWAII, MASSACHUSETTS, MINNESOTA, BUFFALO, NEWARK, PHILADELPHIA, AND SEATTLE APPLICANTS: DO NOT ANSWER THE QUESTION BELOW AT THIS TIME.

Please note that you do NOT have to identify a record of any adult or juvenile arrest, detention or conviction that has been sealed, expunged, annulled, erased, pardoned or statutorily eradicated, set aside or otherwise dismissed by court order.

Please note that answering “YES” to this question will not automatically bar you from employment. Only those crimes which are substantially related to the position you are seeking will be considered.

If, subject to the State-Specific Instructions below, you have more than one conviction, please use additional paper to provide the information requested above.

Applicant may include verifiable work performed on a volunteer basis.

Starting with your most recent employer, provide the following information.

Please Provide two references (business or personal)

I certify that all information I have provided in order to apply for and secure work with this employer is true, complete and correct.

I expressly authorize, without reservation, the employer, its representatives, employees or agents to contact and obtain information from all references (personal and professional), employers, public agencies, licensing authorities and educational institutions and to otherwise verify the accuracy of all information provided by me in this application, resumé or job interview. I hereby waive any and all rights and claims I may have regarding the employer, its agents, employees or representatives, for seeking, gathering and using truthful and non–defamatory information, in a lawful manner, in the employment process and all other persons, corporations or organizations for furnishing such information about me.

I understand that this employer does not lawfully discriminate in employment and no question on this application is used for purpose of limiting or elimination any applicant from consideration for employment on any basis prohibited by applicable local, state or federal law.

I understand that this application remains current for only 30 days. At the conclusion of that time, if I have not heard from the employer and still wish to be considered for employment, it will be necessary for me to reapply and fill out a new application.

If I am hired, I understand that I am free to resign at any time, with our without cause and with or without prior notice, except as may be required by law. This application does not constitute an agreement or contract for employment for any specified period or definite duration. I understand that no supervisor or representative of the employer is authorized to make any assurances to the contrary and that no implied oral or written agreements contrary to the foregoing express language are valid unless they are in writing and signed by the employer’s president.

I also understand that if I am hired, I will be required to provide proof of identity and legal authorization to work in the United States and that federal immigration laws require me to complete an I-9 Form in this regard.

This Company does not tolerate unlawful discrimination in its employment practices. No question on this application is used for the purpose of limiting or excluding an applicant from consideration for employment on the basis of his or her sex, race, color, religion, national origin, citizenship, age, disability, or any other protected status under applicable federal, state, or local law. This Company likewise does not tolerate harassment based on sex, race, color, religion, national origin, citizenship, age, disability, or any other protected status. The Company takes all complaints of harassment seriously and all complaints will be investigated promptly and thoroughly.

I understand that any misrepresentation or omission of facts called for may result in refusal to hire or, if hired, may result in my dismissal at any time regardless of when the false answer or omissions are

DO NOT SIGN UNTIL YOU HAVE READ THE ABOVE APPLICANT STATEMENT.

I certify that I have read, fully understand and accept all terms of the foregoing Applicant Statement.