Cleaning Housekeeping Service Job Application Form

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.
E-mail*
Application Date*

MonthDayYear
Full Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Day Time Phone*

Area CodePhone Number
How did you hear about us?
If you are referred by a person, please submit name and last name below:

First NameLast Name
Date You Are Available to To Start Working*

MonthDayYear
Do You Have Previous Housekeeping or Residential Cleaning Experience?*

YesNo
Are You Legally Eligible to Work in the U.S.? *

YesNo
Are You at Least 18 Years Old?*

YesNo
Are You Able to Pass a Background Check?*

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

YESNO
Do you have reliable transportation?*

YESNO
Do you have a smartphone?*

YESNO
How Many Hours Per Week Would You Like to Dedicate Working for CleanUp?*

0-1010-2020-3030-4040+
What Days Are You Most Interested in Working? (Mark all that apply)*

MondayTuesdayWednesdayThursdayFridaySaturdaySunday
What Times of Day Are You Most Interested In Working?*

MorningsAfternoonsEvenings
WORK STATUS/ REFERENCES

Please list your current employer, if applicable, and 3 non-related references
Are you currently employed somewhere?*

YESNO
Employer's Name
Position Held
Supervisor's Name
Telephone

Area CodePhone Number
Start Date

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

YESNO
If NO, reason why not
Are you planning to stay with your current employer while working at CleanUp?

YES, I plan to keep my current job while working at CleanUpNO, I intend to use CleanUp as my only source of income
We DO NOT consider OR interview anyone who cannot provide 3 references (work, education or personal). NO FAMILY MEMBERS.
Reference (1) Name*
Reference (1) Telephone*

Area CodePhone Number
E-mail
example@example.com
Reference (2) Name*
Reference (2) Telephone*

Area CodePhone Number
E-mail
example@example.com
Reference (3) Name*
Reference (3) Telephone*

Area CodePhone Number
E-mail
example@example.com
OTHER QUESTIONS
How would you describe your cleaning habits?*

Clean Freak!Pretty TidyDon't care too much about cleaning but don't mind doing itOther
How do you feel about being your own boss and managing your own schedule?*

My ultimate professional goal and I am sure I can be good at itSounds good but I am not sure if i can be good at itI work better with the support of a management team/leader
What are your views on customer services and getting excellent reviews?*

My number one priorityImportant but not a priorityDon't really care/know much about it, I can benefit from some guidance on this topic
What is the procedure in general for cleaning any room in a house?*

Work your way in a circle cleaning everything, top to bottom, as you goClean up to down working your way around so not to miss anythingClean the more difficult areas first and the easier areas last
What would you do if there was a $20 bill laying on a table with no note?*

Take the money as a tipAsk the client if it is meant for youLeave it where it is. You don't know if it was meant for you
Do you have or are you able to acquire your own cleaning products and equipment before being placed on the registry?*

Yes, I already have my own equipment and suppliesNo, but I am acquiring my own equipment and supplies before being placed on the registryNo, I don't have any equipment and/or supplies
If you answered yes to the question above, please mark the cleaning tools you have available to complete a cleaning job:*

BroomDust PanMopBucketVacuumToilet BrushSpray BottlesScrub BrushesSponges/ragsI don't have any cleaning tools
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We Need Cleaning Professionals!

WORK STATUS/ REFERENCES

We DO NOT consider OR interview anyone who cannot provide 3 references (work, education or personal). NO FAMILY MEMBERS.

OTHER QUESTIONS