Employment Application Form

Employment Application

All information obtained in this form will be held confidential. We will not discriminate because of sex, age, race, physical disability, religion, ethnicity, marital status, ancestry, or place of origin.
Application Date

MonthDayYear
FULL NAME

First NameLast Name
HOME ADDRESS

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
DAY TIME PHONE

Area CodePhone Number
EMAIL
DATE YOU ARE AVAILABLE TO START WORK

MonthDayYear
What year did you graduate from High School?
ARE YOU LEGALLY ELIGIBLE TO WORK IN THE USA
DO YOU HAVE YOUR OWN VEHICLE (that you don't share) ? **This is required for this job
DO YOU SMOKE?
ARE YOU WILLING TO TAKE A DRUG SCREENING TEST? *We require a Drug Screening for all employees*
DO YOU HAVE ANY MISDEMEANORS OR FELONIES WITHIN THE PAST 12 YEARS? *We require a Criminal Background Check for all employees*
IF YES, PLEASE EXPLAIN:
DO YOU HAVE A CURRENT VALID DRIVERS LICENSE?
This job requires employees to climb stairs, do lots of bending, squatting, and lift up to 40lbs. Will you be able to meet these requirements?
HOW MANY HOURS (per week) DO YOU PREFER TO WORK?
WHAT DAYS ARE YOU MOST INTERESTED IN WORKING?
WHAT TIMES OF DAY DO YOU PREFER TO WORK?
HOW MUCH PER HOUR DO YOU HOPE TO BE PAID?
WHAT AREA ARE YOU AVAILABLE TO WORK?
HOW DID YOU HEAR ABOUT THIS JOB OPENING?
WHY SHOULD WE HIRE YOU?
HOW DO YOU FEEL ABOUT RESPECTFUL CONSTRUCTIVE CRITICISM?
IF WE HIRE YOU, WE WILL CALL YOUR PREVIOUS EMPLOYERS. WHAT DO YOU THINK THEY WILL SAY ABOUT YOU?
ATTENDANCE IS CRUCIAL IN OUR BUSINESS SO WE ASK YOUR PREVIOUS EMPLOYERS ABOUT THIS. HOW PUNCTUAL HAVE YOU BEEN WITH YOUR PREVIOUS EMPLOYERS?
What has been the most stressful situation you have ever found yourself in at work? How did you handle it?
WORK HISTORY / EXPERIENCE

Please list your 3 most current work history/experience
EMPLOYER'S NAME (Most current)
POSITION HELD
Pay Rate?
SUPERVISOR'S NAME
Supervisor's Telephone

Area CodePhone Number
REASON YOU LEFT
YOUR JOB RESPONSIBILITIES
DID YOU GIVE A 2 WEEK NOTICE TO THIS EMPLOYER BEFORE YOU LEFT?
START DATE

MonthDayYear
END DATE

MonthDayYear
May we contact this employer? (please check one)
If NO, reason why not
(2) EMPLOYER'S NAME (If none then put N/A in each section below)
POSITION HELD
Pay Rate?
SUPERVISOR'S NAME
SUPERVISOR'S NUMBER

Area CodePhone Number
REASON YOU LEFT:
YOUR JOB RESPONSIBILITIES:
DID YOU GIVE A 2 WEEK NOTICE BEFORE YOU LEFT?
START DATE

MonthDayYear
END DATE

MonthDayYear
May we contact this employer? (please check one)
If NO, reason why not
(3) EMPLOYER'S NAME
Position Held
Pay Rate?
Supervisor's Name
SUPERVISOR'S NUMBER

Area CodePhone Number
Reason for Departure
Duties
Did you give a 2 week notice to this employer?
Start Date

MonthDayYear
End Date

MonthDayYear
May we contact this employer? (please check one)
If NO, reason why not
YOUR CLEANING PROCESS
How would you dust a shelf with picture frames on it?
What is the procedure in general for cleaning any room?
What qualities do you have that will make you a good professional cleaner
Everyone has weaknesses. Name your weakness that you would like to improve?
Name your strengths as an employee
Is there anything else that you would like to say on your application?
We don't consider or interview anyone who cannot provide 3 references (work, education or church related). Family and friends can't be used as a valid reference.
Reference (1) Name
Reference (1) Telephone

Area CodePhone Number
Reference (2) Name
Reference (2) Telephone

Area CodePhone Number
Reference (3) Name
Reference (3) Telephone

Area CodePhone Number
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 Totally Tidy Maid & Janitorial Services, LLC , 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 Totally Tidy Maid & Janitorial Services, LLC policies, rules, and procedures. I understand that Totally Tidy Maid & Janitorial Services, LLC 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.
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