Last Name
First Name
Email
Address
Phone Number
Employment History (last 2 employers)
Employer
Start Date
End Date
Work Performed
Salary
Education Level
Have you been convicted of a felony?
YesNo
If Yes, what felony?
Do you have your own transportation?
Available Shift:
Part-TimeFull-Time
DayEvening
Are you 18 Years or older?
Will you pass a drug test?
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)
Do you have cleaning Experience?
If yes, how many years?
Please leave this field empty.
