Independent Contractor Application

Independent Contractor Application

Fill the form below accurately indicating your potentials and suitability to job applying for.
Name*

First NameLast Name
Birth Date*

MonthDayYear
Phone Number*
Format: (000) 000-0000.
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState

Zip Code
How were you referred to us?*

Walk-InReferralNewspaper AdFacebookTwitterLinkedInOther
CLEANING EXPERIENCE
Do you have professional cleaning experience?*

YesNo
If so, how many years?*
Do you current have liability insurance and can provide a copy?*

YesNo
If NO, are you willing to obtain insurance?*
If you already have insurance please input "N/A"
Where is the main zipcode you would like to service?*
Enter zipcode where you would like to work
How far are you willing to travel? *
How far from the zipcode you enter above would you like drive ?
How soon can you start work? *

MonthDayYear
Date
Do you have a website or any social media for your business?*

YesNo
If so, please share 😊!!!*
If no please put input "N/A"
Should be Empty:

CLEANING EXPERIENCE