Employment Application

Full Name *

Mailing Address *

City *

State *

ZIP Code *

Phone *

Email *

Date of Birth *

Date Available to Start *

Driver License Number *

Social Security Number *

Are you legally allowed to work in the USA? *

YES

NO

Type of employment desired (check all that apply): *

Have you ever pleaded guilty or been convicted of a crime? *

YES

NO

Answering yes to this question does no constitute an automatic rejection for employment. Date of the offence, seriousness and nature of the violation, and rehabilitation applied will be considered.

If you have pleaded guilty or been convicted of a crime, provide the dates and details below.

May we run a background check on you? *

YES

NO

If asked, could you pass a drug test? *

YES

NO

If you do not believe you would pass a drug test, please explain why not.

References

Name

Relationship

Contact Number

Name

Relationship

Contact Number

Name

Relationship

Contact Number

Employment History

Have you ever worked for a cleaning company before? *

YES

NO

May we contact your previous employer? *

YES

NO

If you prefer that we not contact your previous employer, please explain.

Name of Company

Supervisor

Contact Number

Previous Employment

Name of Company

Start Date

End Date

City

State

Supervisor

Phone

May we contact your previous supervisor?

YES

NO

Reason for leaving:

Qualifications

Describe any special skills and qualifications: *

Why do you think you're a good fit for this job? *

Check all that apply to you:

I affirm that the above information is true and accurate and that by typing my name and today's date below and by submitting this form, I am submitting my application for employment.

Full Name *

Date *