Job Application (English)

We Need Green Cleaning Professionals!

All persons entered in our domestic registry must agree to use eco-friendly, non-toxic products! All information obtained in this form will be held in strict confidence, subject to applicable law. We will not discriminate because of sex, age, race, physical disability, religion, ethnicity, marital status, ancestry, or place of origin.
Application Date

MonthDayYear
Full Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Day Time Phone

Area CodePhone Number
E-mail
Referred By

First NameLast Name
Date You Are Available to Start Work

MonthDayYear
Are You Legally Eligible to Work in the U.S.?
Are you willing to take a drug test?
Are you willing to forgo a background check?
Do you have a valid driver's license?
Do you have a car?
Do you have auto insurance?
Desired Salary/Wage
How Many Hours Do You Want to Work Per Week?
What Days Are You Most Interested in Working?
How Long do you See Yourself Working Here?
What Times of Day Are You Most Interested In Working?
WORK HISTORY / EXPERIENCE

Please list your 3 most current work history/experience
Please Describe Your Work Experience and What Makes You a Perfect Candidate as a Professional Cleaner
Employer's Name (Most current)
Position Held
Supervisor's Name
Telephone

Area CodePhone Number
Reason for Departure
Duties
Start Date

MonthDayYear
End Date

MonthDayYear
May we contact this employer? (please check one)
If NO, reason why not
(2) Employer's Name
Position Held
Supervisor's Name
Telephone

Area CodePhone Number
Reason for Departure
Duties
Start Date

MonthDayYear
End Date

MonthDayYear
May we contact this employer? (please check one)
If NO, reason why not
(3) Employer's Name
Position Held
Supervisor's Name
Telephone

Area CodePhone Number
Reason for Departure
Duties
Start Date

MonthDayYear
End Date

MonthDayYear
May we contact this employer? (please check one)
If NO, reason why not
High School Graduation Year:
Highest Graded Completed
Have you attended College?
Please provide 3 references (work, education, etc.). NO FAMILY MEMBERS.
Reference (1) Name
Reference (1) Telephone

Area CodePhone Number
Reference (2) Name
Reference (2) Telephone

Area CodePhone Number
Reference (3) Name
Reference (3) Telephone

Area CodePhone Number
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We Need Green Cleaning Professionals!

WORK HISTORY / EXPERIENCE

Please provide 3 references (work, education, etc.). NO FAMILY MEMBERS.