House Cleaning Contact | Absolutely Spotless

Date: *

Referred by:

Position Applying for: *

Personal Information

Last Name: *

First Name: *

Middle Name:

Email: *

Address: *

Address:

City

State/Province

Zip/Postal

Home Phone: *

Mobile Phone: *

Other:

***YOU WILL BE REQUIRED TO BRING WITH YOU A SOCIAL SECURITY CARD AND VALID DRIVERS LICENSE TO BE COPIED IF HIRED***

In case of emergency, please contact:

Full Name:

Phone:

Relationship:

Full Name:

Phone

Relationship:

More Info

Make & Model of Your Vehicle:

Color:

License Plate:

Do you have transportation to and from work? *

Yes

No

If hired, when can you start? *

Have you ever been convicted of a criminal offense? *

No

Yes

If yes, please explainIf yes, please explain

Have you ever been bonded?

No

Yes

Has your driver's license ever been suspended?

No

Yes

How long have you been a resident of Las Vegas? Months/Years

Can you read and/or speak English?

Would you have difficulty standing, bending or kneeling in connection with performing necessary cleaning duties?

No

Yes

Work Experience

Provide 3 last employers, starting with your present or last place of employment:

Employer 1 Hire Date: *

Last Day of Employment: *

Position: *

Salary: *

Name of Employer 1: *

Address of Employer 1: *

Address of Employer 1:

City

State/Province

Zip/Postal

Supervisor's Name: *

Supervisor's Phone: *

Reason for Leaving: *

Employer 2 Hire Date:

Last Day of Employment:

Position:

Salary:

Name of Employer 2:

Address of Employer 2:

City

State/Province

Zip/Postal

Supervisor's Name:

Supervisor's Phone:

Reason for Leaving:

Employer 3 Hire Date:

Last Day of Employment: *

Position:

Salary:

Name of Employer 3:

Address of Employer 3:

City

State/Province

Zip/Postal

Supervisor's Name:

Supervisor's Phone:

Reason for Leaving:

Employment Application

Personal Information

In case of emergency, please contact:

More Info

Work Experience