Cleaning Job Application Form

We're looking for Full Time, Part Time, and 1099 Contract Cleaners. Are you the right person for the job?

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.
E-mail
example@example.com
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
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
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*

MonthDayYear
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
Personal Referrences
Reference (1) Name*
Reference (1) Telephone*
Reference (2) Name*
Reference (2) Telephone*
Reference (3) Name*
Reference (3) Telephone*
If hired do you have or are you able to acquire your own cleaning products and equipment?*

Yes, I already have my own equipment and supplies.No, but I am acquire my own equipment and supplies.No
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We're looking for Full Time, Part Time, and 1099 Contract Cleaners. Are you the right person for the job?

WORK HISTORY / EXPERIENCE

Personal Referrences