Cleaning Job Application Form

We Need Professionals!

All persons entered in our domestic registry must agree to use eco-friendly, non-toxic products! 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
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
WORK HISTORY / EXPERIENCE

Please list your 3 most current work history/experience
Please describe your experience and what makes you a true professional cleaner
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?

YesNo
(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?

YesNo
(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?

YesNo
YOUR CLEANING PROCESS
This kitchen has not been cleaned in two weeks. Please describe 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?

Dust the shelf and clean around the nicknacks.Remove the nicknacks, dust the shelf and line the nicknacks up.Remove the nicknacks, dust them 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, top to bottom, as you go.Clean up to down working your way around so not to miss anything.Clean the more 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 do you dust a picture on the wall that has no glass?

Don't dust it. You don't want to damage itDust only the frame.Dust the entire picture.
We DO NOT consider OR interview anyone who cannot provide 3 references (work, education or church related). NO FAMILY MEMBERS.
Reference (1) Name

First NameLast Name
Reference (1) Telephone
Reference (2) Name

First NameLast Name
Reference (2) Telephone
Reference (3) Name

First NameLast 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 the company, 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 company policies, rules, and procedures. I understand that the company 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. I have never been convicted of a felony and I have no criminal charges pending against me.
Do you have or are you able to acquire your own cleaning products and equipment before being placed on the registry? YOUR CLEANING PRODUCTS MUST BE ECO-FRIENDLY AS A CONDITION OF BEING PLACED ON THE REGISTRY.

Yes, I already have my own equipment and supplies.No, but I am acquire my own equipment and supplies before being placed on the registry.No
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