Simple Job Application Form

We Need Cleaning Professionals!

Ten-33 Cleaning Service is committed to a policy of equal employment opportunity and will not discriminate on any legal recognized basis, including but not limited to race, age, color, religion, sex, marital status, national origin, citizenship, ancestry, physical or mental disability, veteran status, or any other legally protected basis.
Application Date

MonthDayYear
Date
Full Name

First NameMiddle NameLast Name
List any other legal last name (maiden and/or previous married last names).*
Birth Date

MonthDayYear
Current Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
List all previous addresses over the last 5 years:
Email Address
example@example.com
Phone Number
Position Applied
How did you hear about us
Available Start Date

MonthDayYear
Date
Upload Your Resume

Cancelof
Are you legally eligible to work in the U.S.?

YesNo
Are you willing to take a drug test?

YesNo
Have you ever been charged and/or convicted of a criminal offense? If yes, please explain.
Have you ever been bonded? If yes, please explain.
Driver's License #:
Date Issued

MonthDayYear
Date
Expiration Date

MonthDayYear
Date
Driving is a requirement for the job. Do you have a valid driver's license? If no, please explain.
Do you have full time access to a vehicle?

YesNo
Is your vehicle covered by comprehensive liability insurance?

YesNo
How many hours can you work per week?

0-1010-2020-3030-4040 +
What days are you most interested in working? (Check all that apply)

MondayTuesdayWednesdayThursdayFridaySaturdaySunday
What time of day are you most interested in working? (Check all that apply)

MorningsAfternoonsEvenings
Are you able to bend, stand, and kneel in order to complete necessary tasks for the job?
Work History / Experience.

Please list your 3 most recent work history / experiences.
Employer's Name (Most Recent)
Position Held
Supervisor's Name
Telephone Number
Reason for Departure
Duties
Start Date

MonthDayYear
Date
End Date

MonthDayYear
Date
May we contact this employer?

YesNo
If No, please explain:
(2) Employer's Name
Position Held
Supervisor's Name
Telephone Number
Reason for Departure
Duties
Start Date

MonthDayYear
Date
End Date

MonthDayYear
Date
May we contact this employer?

YesNo
If No, please explain:
(3) Employer Name
Position Held
Supervisor's Name
Telephone Number
Reason for Departure
Duties
Start Date

MonthDayYear
Date
End Date

MonthDayYear
Date
May we contact this employer?

YesNo
If no, please explain:
Education Background
Highest Level of Education:

Some HighschoolHighschool Diploma / GEDSome CollegeTrade SchoolUndergraduate DegreeGraduate Degree
Name of High School
Diploma / GED Received:

YesNo
Dates Attended (MM/YYYY - MM/YYYY)
Name of College/Graduate School/Trade School:
Degree Received (If any):
Dates Attended (MM/YYYY - MM/YYYY)
Please describe your cleaning experience and what makes you a true professional cleaner.
How would you dust a shelf with many knicknacks on it?

Dust the shelf and clean around the knicknacks.Remove the knicknacks, dust the shelf and line the knicknacks up.Remove the knicknacks, dust the shelf along with the knicknacks and place them back as they were.
What is the procedure in general for cleaning any room in a house?

Work your way in a circle, cleaning everything from top to bottom as you go.Clean top to bottom working your way around so not to miss anything.Clean the most difficult areas first and the easier areas last.
What would you do if there was a $20 bill laying on a table with no note?

Take the money as a tip.Ask the client if it is meant for you.Leave it where it is. You don't know if it was meant for you.
How would you dust a picture on the wall that has no glass in the frame?

Don't dust it. You don't want to damage it.Dust only the frame.Dust the entire picture / frame.
We DO NOT consider OR interview anyone who cannot provide 3 reference (work, education, or church related). NO FAMILY MEMBERS.
Reference (1) Name / Relationship
Telephone Number
Reference (2) Name / Relationship
Telephone Number
Reference (3) Name / Relationship
Telephone Number
PLEASE READ THE FOLLOWING STATEMENTS CAREFULLY BEFORE SIGNING THIS APPLICATION. ONLY THOSE APPLICATIONS WHICH ARE SIGNED AND DATED ARE CONSIDERED VALID. IF YOU HAVE ANY QUESTIONS REGARDING THIS STATEMENT, PLEASE ASK BEFORE SIGNING.
Applicants Statement. In signing this application, I certify that all of the foregoing information is a complete and accurate statement of the facts and understand that if any misrepresentation, omission or falsification be discovered, it will constitute grounds for dismissal. I hereby authorize Ten-33 Cleaning Service, LLC, to which I am applying, to conduct any investigation necessary concerning any part of my background related to the position I am seeking, including but not limited to, the obtaining of a police report or driving record regarding my employment, education, character and qualifications. I release all parties from any liability in connection with the provision and use of such information.

YesNo
I understand and agree that, if employed by Ten-33 Cleaning Service, LLC, I will be responsible for familiarizing myself with all rules and regulations of Ten-33 Cleaning Service, LLC, as they presently exist or are later modified, and that I will abide by its rules and regulations which I understand are subject to change.

YesNo
I also understand that no representative of Ten-33 Cleaning Service, LLC, has any authority to enter into any employment agreement for any specified period, or to assure me of any future position, benefits, or terms and conditions of employment. I further understand that, if hired, my employment is for no definite period of time and may be terminated by either party at any time.

YesNo
I have read, understood and agree with the above statements. (Type Signature)
This application is current for only 60 days from the date of submission. At the conclusion of this time, if you still wish to be considered for employment, it will be necessary to complete a new application. Thank you for your interest in employment with Ten-33 Cleaning Service. We will contact you at our earliest convenience.
Should be Empty:

We Need Cleaning Professionals!

Work History / Experience.

Education Background

We DO NOT consider OR interview anyone who cannot provide 3 reference (work, education, or church related). NO FAMILY MEMBERS.

PLEASE READ THE FOLLOWING STATEMENTS CAREFULLY BEFORE SIGNING THIS APPLICATION. ONLY THOSE APPLICATIONS WHICH ARE SIGNED AND DATED ARE CONSIDERED VALID. IF YOU HAVE ANY QUESTIONS REGARDING THIS STATEMENT, PLEASE ASK BEFORE SIGNING.