Employment Application

Name:*

First NameLast Name
Birth Date*

MonthDayYear
Phone Number:*
E-mail Address:*
example@example.com
Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
When can you start?*

Right away!Within 2 weeksLonger than 2 weeks from nowOther
Do you have any professional house cleaning experience?*

YesNo
Are you legally eligible to work in the United States?*

YesNo
Do you have a valid driver's license?*

YesNo
Do you have reliable transportation with proper insurance?*

YesNo
Can you pass a drug test and background check?*

YesNo
Are you able to preform the tasks associated with cleaning houses including, but not limited to: standing for 8 hours, walking up and down stairs, bending, kneeling, and lifting 50 pounds?*

YesNo
How many hours per week would you like to work?*

0-1011-2021-3031-40
What days are you most interested in working?*

MondayTuesdayWednesdayThursdayFridaySaturdaySunday
What times are you most interested in working?*

MorningsAfternoonsEvenings
Job Skills & Training
Describe your applicable experience or skills:
References

Please list two (2) references that are familiar with your work life.
Reference 1
Name:*

First NameLast Name
Phone Number*
Years Known:*
How do they know you?*
Reference 2
Name:*

First NameLast Name
Phone Number*
Years Known:*
How do they know you?*
Do you understand that we may photograph or video you for our use on our social media pages, website, or other media outlets? We are very active online and photos of our great team help show our customers who they are hiring.*

YesNo
Upload Resume

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