Elite Cleaning

Your Information Work Location:

Salutation: First Name: Last Name:

Current Address: Social Security No:

Current City: State: Zip:

Previous Address:

Previous City: State: Zip:

Date of Birth: Email Address:

Date Available: Phone: Drivers License: State:

Your Desired Status and Availability Select All That Apply

Desired Status:

Any Available:

Full Time:

Part Time:

Days Available:

Any Day:		Sunday:		Monday:		Tuesday:
Wednesday:		Thursday:		Friday:		Saturday:

Time Available:

Any Time:		12AM - 4AM:		4AM - 8AM:		8AM - 12PM:
12PM - 4PM:		4PM - 8PM:		8PM - 12AM:

Your Physical Abilities

Can you lift at least 50 pounds? If No, describe:

Do you have any physical limitations? If Yes, describe:

Are you under a physicians care? If Yes, describe:

Do you use medical marijuana? If Yes, describe:

Tell Us About Yourself

Do you have a vehicle?

Do you have a criminal record? If Yes, describe:

Have you ever been fired from a job? If Yes, describe:

Do you have any special skills? If Yes, describe:

Hobbies or interests? If Yes, describe:

Have you applied with us before? If Yes, describe:

Have you ever worked for us? If Yes, describe:

Are you currently employed? If Yes, may we contact your employer?

Are you a US citizen? If No, are you in the country legally?

Work Experience Select All That Apply

Do you have HANDS ON EXPERIENCE with any of the following equipment or processes?

Electric Buffer:	Propane Buffer:	Auto Scrubber:
Slow Speed Scrubber:	Carpet Machine:	Commercial Cleaning:
Floor Wax Stripping:	Tile and Grout Cleaning:	Floor Wax Application:

Employment History

Company: Employer One

Supervisor: First Name: Last Name:

Address:

City: State: Zip:

Phone: Email Address:

Date Started: Date Left: Salary:

Reason for leaving:

Your Job Duties:

Company: Employer Two

Supervisor: First Name: Last Name:

Address:

City: State: Zip:

Phone: Email Address:

Date Started: Date Left: Salary:

Reason for leaving:

Your Job Duties:

References

Relationship: Reference One

Salutation: First Name: Last Name:

Phone: Email:

Relationship: Reference Two

Salutation: First Name: Last Name:

Phone: Email:

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