Cleaning Job Application Form

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 To Start Work

MonthDayYear
Are You Legally Eligible to Work in the U.S.?
Do you have a valid driver's license?
How Many Hours Do You Want to Work Per Week?
What Days Are You Available to working?
WORK HISTORY / EXPERIENCE

Please list your 3 most current work history/experience
Please Describe Your Cleaning Experience and What Makes You a True 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
YOUR CLEANING PROCESS
This kitchen has not been cleaned in two weeks. Please descibe in bullet points how you would clean this room and the products you would use.
How wood you dust a shelf with many knicknacks on it?
What is the procedure in general for cleaning any room in a house?
What would you do if there was a $20 bill laying on a table with no note?
How do you dust a picture on the wall that has no glass?
We DO NOT consider OR interview anyone who cannot provide 3 references (work, education or church related). 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
False information will cause removal from our registry.

I hereby state that all information provided is accurate and may be verified by you. I agree that I may be discharged if this company at anytime learns of falsification or material omission in the information provided on this application form and related documents. You may contact my former employers. All references are hereby authorized to release all information which they may have relevant to my employment with them. I hereby release Southern Comfort Cleaning, its affiliates, successors, and assigns, and all references from any liability that might be claimed because of information provided by such references. I agree that I will follow all Southern Comfort Cleanings policies, rules, and procedures. I understand that Southern Comfort Cleaning reserves the right to add, change, and/or delete any policies, procedures, work rules, and/or benefits at anytime.I have never been convicted of a felony and I have no criminal charges pending against me.
Do you have reliable transportation and your own vacuum? (click all that apply)
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