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Name *

First

Last

Address *

Address Line 1

City

State

Zip Code

Email *

Phone *

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Date of Birth

Are you over 18 years

What Languages do you Speak?

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Emergency Contact Person Name

Emergency Contact Person Number

Our hours of operation are Monday's through Friday's, 7:30 am to 4 pm

Are you looking for full-time work?
Are you looking for part-time work, what days of the week are you available?

Do you have any physical limitations that would inhibit you from safely cleaning, such as bending, kneeling, push & pulling or lifting up to 25 pounds repeatedly throughout the workday?

Do you have severe allergies to any household cleaning products such as but not limited to: vinegar, baking soda, mild detergent or natural cleaning products? If yes: list allergies please:

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Are you severely allergic to cats or dogs or other household type pets?

Are you comfortable being in a client's home with their pets?

Social Security number / Tax Id:

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Are you authorized to work in the U.S.?

Do you have a valid driver's license?

Not required, but do you have your own vehicle that is in good working condition?

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Make

Model

Plate

Do you agree to allow us to perform a background check that meets all Massachusetts laws:

Employment History

Do you have any cleaning experience?

Are you currently employed?

Have you ever been terminated from any employer?

Employment History with most recent listed first

Name

Address

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Supervisor / Owner Contact

Position

Salary

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Start Date

End Date

Reason for Leaving?

Can you provide 3 references with at least 1 of them being a professional references that can personally speak for your skills and experience? Please are you able to provide us with their names and contact phone numbers?

What about our company attracts you and makes you wish to be a part of our family team?

Do you know anyone who is currently working with us or has in the past?

Please, how were you referred to us at this time?

How soon are you available to start?

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