Last Name*

First Name*

Email*

Address*

Phone Number*

Employment History (last 2 employers)

Education Level*

Have you been convicted of a felony?*

YesNo

If Yes, what felony?

Do you have your own transportation?*

YesNo

Available Shift*:

Part-TimeFull-Time

DayEvening

Are you 18 Years or older?*

YesNo

Will you pass a drug test?*

YesNo

What hourly rate are you looking to make?* (Minimum wage is
$8.50)

Are you prevented from lawfully becoming unemployment in this
county due to VISA or immigration status?* (Proof of citizenship

or immigration status is regarded upon employment)

YesNo

Do you have cleaning Experience?*

YesNo

If yes, how many years?

Please leave this field empty.