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CLEANING SPECIALIST APPLICATION

An Equal Opportunity Company

Maid For You is an equal opportunity company. This application will not be used for limiting or excluding any applicant from consideration for contractment on a basis prohibited by local, state, or federal law. Applicants requiring reasonable accommodation in the application and/or interview process should notify a representative of the organization.

Name*

Current Address*

Phone Number*

Email Address*

Are you applying for:*

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What days and hours are you available for work?*

If hired, what date can you start working?*

Can you work weekends?*

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Can you work evenings?*

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Are you available to work overtime?*

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Salary Desired*

If hired, would you have your own reliable transportation to/from work?*

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Have you ever been convicted of a criminal offense (felony or misdemeanor)?*

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If yes, please describe the crime - state nature of the crime(s), when and where convicted and disposition of the case.*

High School Education (School Name, Address)*

Number of High School years completed*

Did you graduate from High School?*

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College/Univeristy Education (School Name, Address)*

Number of College/University years completed*

Did you graduate from College/University?*

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Do you have any other experience, training, qualifications or skills which you feel should be brought to our attention in the case that they make you especially suited for working with us?*

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If yes, please explain

EMPLOYMENT HISTORY - Are you currently Employed*

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If you are currently employed, may we contact your current employer?*

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1. NAME OF EMPLOYER*

Name of Supervisor*

Telephone Number*

Business Type*

Address (Street, City, State Zip)*

Length of Employment (Include Dates)*

Position & Duties:*

Reason For Leaving*

2. NAME OF EMPLOYER*

Name of Supervisor*

Telephone Number*

Business Type*

Address (Street, City, State Zip)*

Length of Employment (Include Dates)*

Reason For Leaving*

Position & Duties:*

3. NAME OF EMPLOYER*

Name of Supervisor*

Telephone Number*

Business Type*

Address (Street, City, State Zip)*

Length of Employment (Include Dates)*

Position & Duties:*

Reason for Leaving*

1. PERSONAL/PROFESSIONAL REFERENCE - Reference Name (First, Last)*

Phone Number*

Occupation*

Number of Years Acquainted:*

2. PERSONAL/PROFESSION REFERENCE - Reference Name (First, Last)*

Phone Number*

Occupation*

Number of Years Acquainted:*

3. PERSONAL/PROFESSIONAL REFERENCE - Reference Name (First, Last)*

Phone Number*

Occupation*

Number of Years Acquainted:*

By submitting this application, I certify that I have not purposely withheld any information that might adversely affect my chances for hiring. I attest to the fact that the answers given by me are true & correct to the best of my knowledge and ability. I understand that any omission (including any misstatement) of material fact on this application or on any document used to secure can be grounds for rejection of application or, if I am contracted by this company, terms for my immediate expulsion from the company.

I understand that if I am contracted, my contract is not definite and can be terminated at any time either with or without prior notice, and by either me or the company.

I permit the company to examine my references, record of employment, education record, and any other information I have provided. I authorize the references I have listed to disclose any information related to my work record and my professional experiences with them, without giving me prior notice of such disclosure. In addition, I release the company, my former employers & all other persons, corporations, partnerships & associations from any & all claims, demands or liabilities arising out of or in any way related to such examination or revelation.

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