Take the Next Step! APPLICATION FOR EMPLOYMENT Please fill out the form completely and do not leave anything blank. Name* First Last Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Email* Date of Birth* MM slash DD slash YYYY Can you provide proof of eligibility to become employed in the United States?*YesNoCan you pass a background check?*YesNoDo you have full time access to a smart phone with data?**YesNoDriving is a requirement for the job. Do you have a current valid drivers license?**YesNoDo you have full time access to a vehicle?**YesNoIs the vehicle covered by liability insurance?*YesNoI don't have a vehicleWould you have difficulty standing, bending, or kneeling in connection with performing necessary cleaning duties?*YesNoAre you sensitive to household chemicals?*YesNoAre you highly allergic to dogs and/or cats?*YesNoAre you afraid of dogs and/or cats?*YesNoHave you ever been terminated or forced to resign from your employment with any employer?*YesNoAre you currently on layoff status and subject to recall?*YesNoEmployment HistoryCurrent or Most Recent Employer. List Company Name, Company Address, Phone Number, Position, Salary, Reason For Leaving, and Dates of Employment (PLEASE ANSWER THOROUGHLY AND DO NOT LEAVE THIS BLANK))Next Most Recent EmployerList Company Name, Company Address, Phone Number, Position, Salary, Dates of Employment, and Reason for LeavingNext Most Recent EmployerList Company Name, Company Address, Phone Number, Position, Salary, Dates of Employment, and Reason for LeavingDo you have at least 1 year of Residential/Home Cleaning experience?*YesNoAre you seeking Part Time or Full Time Work (we are hiring both)*Full time- more than 30 hoursPart time- less than 30 hoursAre you available to work (at minimum) 8 am - 1 pm Monday - Friday?*YesNoTell us why you would like to join our team?By Submitting this application I understand that the Company requires its employees to adhere to the highest standards of business and personal ethics and responsibility. I understand that the Company believes that one method by which such high standards are demonstrated is through the timely meeting of financial obligations. Consequently, I understand and agree that by making application for a position with this company, I am agreeing that my credit worthiness is substantially related to the job for which I am applying or which I hold and that my credit worthiness may be examined by the company. I further understand and agree that this application is not a contract of employment. I understand and agree that the Company adhere to a policy of employment at will which means that either I, or the employer, may terminate my employment at any time, or for any reason, consistent with application of state and federal law. I further understand that this "at will" employment relationship may not be changed by any written document or by conduct unless such change is in a written employment contract naming me and signed by the President of the Company. I understand that to be employed, I must be lawfully authorized to work in the United States and must show the employer documents to prove this. I understand that the Company may investigate my work and personal history and verify the information provided in this application, on related documents or information obtained through other sources and I hereby authorize such investigation. I authorize all individuals, schools, firms and business named in this application or in other documents or interviews, except my current employer if I have so designated in this application, to provide complete and accurate information regarding my relationship with them to the Company. I further release those individuals, schools, firms and business and the Company from any and all liability for damage for providing or requesting such information. I certify that all of the information provided in the entire application process including any information provided in addition to this application including, but not limited to, information provided in resumes or interviews is true and correct. I understand that if there is any falsification or omission, this may lead to the Company’s refusal to hire me or a determination, at any time, that my employment should be terminated. The Company is an Equal Employment Opportunity Employer and considers all applicants without regard to race, color, religion, gender, national origin, age, marital status, veteran’s status, the presence of a mental, physical or sensory disability, sexual orientation, or any other legally protected status. Employment shall be based solely on the needs of the companies and the qualifications of the individuals making application.
