Cleaning Application

Martinez Cleaning LLC: Employment Application
Application Date*

MonthDayYear
Full Name*

First NameMiddle NameLast Name
Address*

Street Address

Street Address 2

CityState / Province

Postal / Zip CodeCountry
Date of Birth*

MonthDayYear
Date
E-mail
example@example.com
Day Time Phone*
Referred By

First NameLast Name
Date You Are Available to To Work*

MonthDayYear
Are You Legally Eligible to Work in the U.S.? *

YesNoOther
Do you have a valid driver's license?*

YESNO
Do you have a cellular device with internet capabilities*

YESNO
How Many Hours Do You Want to Work Per Week?*

0-1010-2020-3030-4040+
What Days Are You Most Interested in Working? *

WeekdaysWeekends
What Times of Day Are You Most Interested In Working?*

MorningsAfternoonsEvenings
Are you able to lift more than 25 pounds regularly?*

YESNO
Are you able to lift 50 pounds or more regularly?*

YESNO
WORK HISTORY / EXPERIENCE

Please list your 2 most current work history/experience
Please Describe Your Green Cleaning Experience and What Makes You a True Professional Cleaner*
Employer's Name (Most current)*
Position Held*
Supervisor's Name*
Telephone*
Reason for Departure*
Job Duties*
Start Date*

MonthDayYear
End Date (Leave blank if still working)

MonthDayYear
May we contact this employer? (please check one)*

YESNO
If NO, reason why not
(2) Employer's Name
Position Held
Supervisor's Name
Telephone
Reason for Departure
Duties
Start Date

MonthDayYear
End Date

MonthDayYear
May we contact this employer? (please check one)

YESNO
If NO, reason why not
This kitchen has not been cleaned in two weeks. Please describe how would you clean this room and in what order.*
How would you dust a shelf with many items on it?*

Dust the shelf and clean around the nicknacks.Remove the nicknacks, dust the shelf and line the nicknacks up.Remove the nicknacks, dust them and place them back as they were.
What is the procedure in general for cleaning any room in a house?*

Work your way in a circle cleaning everything, top to bottom, as you go.Clean up to down working your way around so not to miss anything.Clean the more difficult areas first and the easier areas last.
What would you do if there was a $20 bill laying on a table with no note?*

Take the money as a tip.Ask the client if it is meant for you.Leave it where it is. You don't know if it was meant for you.
How do you dust a picture on the wall that has no glass? *

Don't dust it. You don't want to damage itDust only the frame.Dust the entire picture.
We do background checks after applicants has been hired.
Reference (1) Name*
Reference (1) Telephone*
Reference (2) Name*
Reference (2) Telephone*
Reference (3) Name
Reference (3) Telephone
All persons entered in our domestic registry must agree to use eco-friendly, non-toxic products. All information obtained in this form will be held in strict confidence, subject to applicable law. We will not discriminate because of sex, age, race, physical disability, religion, ethnicity, marital status, ancestry, or place of origin. False information will cause removal from our registry.

I hereby state that all information provided is accurate and may be verified by you. I agree that I may be discharged if this company at anytime learns of falsification or material omission in the information provided on this application form and related documents. You may contact my former employers. All references are hereby authorized to release all information which they may have relevant to my employment with them. I hereby release Martinez Cleaning LLC, its affiliates, successors, and assigns, and all references from any liability that might be claimed because of information provided by such references. I agree that I will follow all Martinez Cleaning LLC policies, rules, and procedures. I understand that Martinez Cleaning LLC reserves the right to add, change, and/or delete any policies, procedures, work rules, and/or benefits at anytime. I agree to make myself available for random drug testing. I have no criminal charges pending against me.
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