Cleaning Job Application Form

We Need Cleaning Professionals!

All information obtained in this form will be held in strict confidence, subject to applicable law. We will not discriminate 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*
E-mail*
example@example.com
Referred By

First NameLast Name
Date You Are Available to To Work*

MonthDayYear
Are You Legally Eligible to Work in the U.S.? *

YesNo
Are you willing to take a drug test? *

YesNo
Do you have a valid driver's license?*

YESNO
How Many Hours Do You Want to Work Per Week?*

0-1010-2020-3030-4040+
What Days Are You Most Interested in Working? *

WeekdaysWeekends
What Times of Day Are You Most Interested In Working?*

MorningsAfternoonsEvenings
Have you been convicted of a felony?
WORK HISTORY / EXPERIENCE

Please list your 3 most current work history/experience
Employer's Name (Most current)*
Position Held*
Supervisor's Name*
Telephone*
Reason for Departure*
Duties*
Start Date*

MonthYear
End Date*

MonthDayYear
May we contact this employer? (please check one)*

YESNO
If NO, reason why not
(2) Employer's Name
Position Held
Supervisor's Name
Telephone
Reason for Departure
Duties
Start Date

MonthDayYear
End Date

MonthDayYear
May we contact this employer? (please check one)

YESNO
If NO, reason why not
(3) Employer's Name
Position Held
Supervisor's Name
Telephone
Reason for Departure
Duties
Start Date

MonthDayYear
End Date

MonthDayYear
May we contact this employer? (please check one)

YESNO
If NO, reason why not
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*
Reference (2) Name*
Reference (2) Telephone*
Reference (3) Name*
Reference (3) Telephone*
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 Fresh Start Cleaning Crew 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 Fresh Start Cleaning Crew policies, rules, and procedures. I understand that Fresh Start Cleaning Crew reserves the right to add, change, and/or delete any policies, procedures, work rules, and/or benefits at anytime. I agree to make myself available for random drug testing.
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We Need Cleaning Professionals!

WORK HISTORY / EXPERIENCE

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

False information will cause removal from our registry.