First & Last Name

Phone Number

Email Address

Street Address

Date Available To Start

State

City

Have you graduated from high school or earned a GED? Have you graduated from high school or earned a GED? Yes No Working on it

Are you eligible to work in the United States? Are you eligible to work in the United States? Yes No

If you are currently employed, why are you looking for a new job?

How many jobs have you had in the last 3 years? -- How many jobs have you had in the last 3 years? --012345+

Why did you leave your last job?

If you are not currently employed, how long have you been unemployed?

Are you tobacco & drug free? Are you tobacco & drug free? Yes No

Are you able to pass a background check? Are you able to pass a background check? Yes No

Are you able to pass a drug test? Are you able to pass a drug test? Yes No

Do you have previous cleaning experience? Do you have previous cleaning experience? Yes No

Do you have a smart phone? Do you have a smart phone? Yes No

Do you have a reliable vehicle? Do you have a reliable vehicle? Yes No

What hours are you available on Mondays?

What hours are you available on Tuesdays?

What hours are you available on Wednesdays?

What hours are you available on Thursdays?

What hours are you available on Fridays?

Reference #1 - Full Name

Reference #1 - Relation

Reference #1 - Company Name

Reference #1 - Phone Number

Reference #2 - Full Name

Reference #2 - Relation

Reference #2 - Company Name

Reference #2 - Phone Number

Reference #3 - Full Name

Reference #3 - Relation

Reference #3 - Company Name

Reference #3 - Phone Number

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