Application

We Need 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.
Application Date*

MonthDayYear
Full Name*

First NameLast Name
Maiden name/previous last names*

Maiden nameAny other former names
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Day Time Phone*

Area CodePhone Number
E-mail*
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
Are you willing to submit to a background check? *

YesNo
Are you currently on probation?

YesNoPrefer not to answer
Do you have a valid driver's license?*

YesNo
Do you have your own reliable vehicle?*

YesNo
How Many Hours Do You Want to Work Per Week?*

0-1010-2020-3030-40
What Hours Would You Prefer To Work?

Mornings (8:30am-12pm)Afternoons (12pm-5pm)Mornings and Afternoons (8:30pm-5pm)Evenings (After 5pm)Afternoons and Evenings (12pm-?)
What Days Are You Most Interested in Working? *

WeekdaysWeekendsWeekdays and Weekends
WORK HISTORY / EXPERIENCE

Please list any cleaning experience and three most current jobs if applicable
Do you have any cleaning experience?

YesNo
Type a question
If YES, please explain:
Employer's Name (Most current)*
Position Held*
Telephone*

Area CodePhone Number
Reason for leaving*
Duties*
Start Date*

MonthDayYear
End Date*

MonthDayYear
May we contact this employer? (please check one)*

YESNO
If NO, please explain:
(2) Employer's Name
Position Held
Telephone

Area CodePhone Number
Reason for Leaving
Duties
Start Date

MonthDayYear
End Date

MonthDayYear
May we contact this employer? (please check one)

YESNO
If NO, please explain:
(3) Employer's Name
Position Held
Telephone

Area CodePhone Number
Reason for Leaving
Duties
Start Date

MonthDayYear
End Date

MonthDayYear
May we contact this employer? (please check one)

YESNO
If NO, please explain:
YOUR CLEANING PROCESS
What would you clean first in any room?*

Ceiling fanFloorCountertops or dresser
How would you dust a shelf with many nicknacks 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, dust the shelf and place the nicknacks back as they were.
What would you do if there was a $10 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 with wood cleaner.Dust the entire picture using a soft duster.
We DO NOT consider OR interview anyone who cannot provide 3 references (work, education, or church related). NO FAMILY MEMBERS.
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 database.

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 Amy Jo's Cleaning Co, 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 of Amy Jo's Cleaning Co policies, rules, and procedures. I understand that Amy Jo's Cleaning Co 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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