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*

MonthDayYear
Full Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Date of Birth:*
Day Time Phone*

Area CodePhone Number
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
Do you have a valid driver's license?*

YESNO
Driver License Number:
Have you ever been convicted of any type of larceny offense?

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

0-1010-2020-3030-4040+
WORK HISTORY / EXPERIENCE

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

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

MonthDayYear
End Date*

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

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

Area CodePhone Number
Reason for Departure
Duties
Start Date

MonthDayYear
End Date

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

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

Area CodePhone Number
Reason for Departure
Duties
Start Date

MonthDayYear
End Date

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

YESNO
If NO, reason why not
Please provide 3 references.
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
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We Need Office Cleaning Professionals!

WORK HISTORY / EXPERIENCE

Please provide 3 references.