Office Cleaning Indepenent Contractor Employement Application

Date Of Application:
Position Applying For:
Area Applying For:

NAME

First
Last
M.I.
S.S. #
ADDRESS
Street
City
State ZIP
Home Phone:
Work Phone:

Cell Phone:
Digital Pager:
E-Mail Address:

APPLICATION

Salary Requirements
Are You Eighteen Or Older? YES NO
Do You Have Reliable Transportation? YES NO
Type Of Transportation
Do You Have A Valid Driver's License? YES NO
If So, Date Of Expiration:
Have You Ever Worked For A Cleaning Services Company Before? YES NO
If Yes, When?
If Yes, What State(s)?
Interested In: (Check All That Apply)
Full-Time Part-Time Temporary
Availability: (Check All That Apply)
Any Time Weekdays Weekends
Any Shift Days Evenings
If not available for anytime/any shift, what days and times are you available?

When can you not work? List times:

Do you plan to work another job? YES NO
If yes, where and what hours?

List ALL Violations Of Any Type During Your Lifetime, Including Any Traffic Violations:

Previous Employers - (Please List The Most Recent First)
Name Of Business
Street Address
City State
Phone
Supervisor
Employed From To (xx/xx/xxxx format)

Skills/Responsibilities:

May we ask your present employer for a reference?
Yes No

Employer 2
Name Of Business
Street Address
City State
Phone
Supervisor
Employed From To (xx/xx/xxxx format)

Skills/Responsibilities:

Employer 3
Name Of Business
Street Address
City State
Phone
Supervisor
Employed From To (xx/xx/xxxx format)

Skills/Responsibilities:

References

List three people, not related to you, that you have known for at least one year: Please list name, phone number, their occupation and how long you've known them. Application Supplement and Reference Release & Waiver

1.
2.
3.

I, , have submitted an application with COMPANY NAME. I certify that all information supplied by me on this employment application is true and accurate and I authorize a complete investigation. I agree that, if hired, I may be discharged if COMPANY NAME., at any time, learns of any falsification or material omission in the information I have provided and if discovered prior to hire, I would be ineligible for hire now and at anytime in the future.

I authorize COMPANY NAME. to contact all former and current employer references listed on my application. All references are authorized to release all information requested. I hereby release COMPANY NAME. and all references from any liability which might be claimed because of information provided by such references.

I understand nothing in COMPANY NAME. employment application is intended to imply or create an employment relationship. I agree that, if hired, I will follow all company policies, rules, procedures, and all other directions.

I further understand that, if hired, my employment is at-will, which means that I may terminate my employment at any time and for any reason, or no reason and that COMPANY NAME. may conclude the employment relationship with me at any time and for any or no reason.

I also understand that, if hired, a $15.00 money order and a business length, stamped envelope is required for a criminal history record request, as specified by State law.

Applicant:

Date (mm/dd/yyyy):

Applications remain active for 60 days. If you wish to be considered for employment after 60 days from the date of this application, you will need to fill out a new application.

COMPANY NAME. Is An Equal Opportunity Employer

Click Here To Go To Independent Contractor Agreement

Click Here To Go To A Follow Up Letter

Click Here To Go To Employment Application

Click Here To Go To Introduction Letter

Click Here To Go To Reminder Letter

Click Here To Go To Service Agreement

Click Here To Go To Service Agreement Part 2

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