Name*

Email*

Phone

Address

Zip Code

Are you authorized to work in the US?*
---YesNo

Are you at least 18?*
---YesNo

Highest education level completed?

Basic Eligibility

Do you have reliable transportation?
YesNo

How will you get to/from work?

Part Time/Full*
---Part TimeFull TimeNo Preference

Work Preference?*
---DayAfternoonEveningsNightsAnytime

Training/Experience

Please list your work experience and skills that qualify you for the job you are applying for:

Past Incidents

Have you been convicted of a crime?
YesNo

If so please describe the nature of the offense(s) and the county/state where occurred:

This information will be used only for job-related purposes and only to the extent permitted by applicable law. Clean Office Plus will consider the offense for which you were convicted, the circumstances surrounding the conviction, and the date of the conviction, as important factors in making its hiring decision.

In case of an emergency please contact

Name

Address

Phone*

Requirements Minimum Physical Requirements including, but not limited to being able to handle/be around the cleaning supplies; some heavy lifting; bending/kneeling required; must be able to stand to long periods of time.

Are you able to lift boxes or equipment weighing up to 50 pounds:
YesNo

I understand and agree that:

1. The information that I have provided on this application is true and complete to the best of my knowledge. Any misrepresentation or omission of any fact in my application, resume, or any other materials, or during any interviews, can be justification of refusal of employment, or, if employed, termination from Clean Office Plus.

2. Employment with Clean Office Plus is at will. This simply means that the employment relationship between Clean Office Plus and yourself is based upon mutual consent and can be terminated at any time by either you or Your Maid Services without notice and without any requirement of cause.

3. Any offer of employment I may receive from Clean Office Plus is contingent upon my successful completion of the company's total pre-employment screening process, including the company's receiving references that it considers satisfactory, and my satisfactory completion of any post offer pre-employment medical examination that the company may require. I also agree, if employed, to submit to a medical examination at any time at the company's request. I hereby consent to having the results of any post offer pre-employment or post employment medical exams I may be required to take disclosed to Clean Office Plus.

4. I understand that as a condition of employment, I may be required to undergo and successfully pass a screening for alcohol and/or drugs. I also understand and agree that, if employed, I may be required to submit to an alcohol or drug screening at any time at the discretion of Clean Office Plus.

5. I authorize any investigator or duly accredited representative of Clean Office Plus bearing this release clause to obtain any information from schools, residential management agents, employers, criminal justice agencies, or individuals, relating to my activities. This information may include, but is not limited to, academic, residential, achievement, performance, attendance, personal history, disciplinary, employment otherwise, arrest, and conviction records. I hereby direct the requested third-party to release such information upon request of Clean Office Plus. I understand that the information released is for official use by Clean Office Plus and may be disclosed to such third parties as necessary in the fulfillment of official responsibilities. I release any individual, including record custodians, from any and all liability for damages of whatever kind or nature which may at any time result to me on account of compliance, or any attempts to comply, with this authorization.

Full Legal Name

Initials

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