Office cleaning application

We Need Office Cleaning Professionals!

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
Application Date *

Month Day Year
Full Name *

First Name Last Name
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Date of Birth: *
Day Time Phone *

Area Code Phone Number
Date You Are Available to To Work *

Month Day Year
Are You Legally Eligible to Work in the U.S.? *

Yes No
Are you willing to take a drug test? *

Yes No
Do you have a valid driver's license? *

YES NO
Driver License Number:
Have you ever been convicted of any type of larceny offense?

Yes No
How Many Hours Do You Want to Work Per Week? *

0-10 10-20 20-30 30-40 40+
WORK HISTORY / EXPERIENCE

Please list your 3 most current work history/experience
Employer's Name (Most current) *
Position Held *
Supervisor's Name *
Telephone *

Area Code Phone Number
Reason for Departure *
Duties *
Start Date *

Month Day Year
End Date *

Month Day Year
May we contact this employer? (please check one) *

YES NO
If NO, reason why not
(2) Employer's Name
Position Held
Supervisor's Name
Telephone

Area Code Phone Number
Reason for Departure
Duties
Start Date

Month Day Year
End Date

Month Day Year
May we contact this employer? (please check one)

YES NO
If NO, reason why not
(3) Employer's Name
Position Held
Supervisor's Name
Telephone

Area Code Phone Number
Reason for Departure
Duties
Start Date

Month Day Year
End Date

Month Day Year
May we contact this employer? (please check one)

YES NO
If NO, reason why not
Please provide 3 references.
Reference (1) Name *
Reference (1) Telephone *

Area Code Phone Number
Reference (2) Name *
Reference (2) Telephone *

Area Code Phone Number
Reference (3) Name *
Reference (3) Telephone *

Area Code Phone Number
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We Need Office Cleaning Professionals!

WORK HISTORY / EXPERIENCE

Please provide 3 references.