PREMIER CLEANING & PROPERTY SERVICES

Employment Application

Name:
First Last Email
Date of Birth:
MM/DD/YYYY
Address:    
Number & Street City State & Zip
Phone:
Home Cell
Emergency Contact:
Name Number
Were you referred? yes no If so, by who?
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Position Desired: Location:
Pay Desired: Hours/Week:
Do you have a vehicle? yes no If no, how would you get to work?
Would you agree to a drug test? yes no Would you agree to a background check? yes no
Have you ever been convicted of, or pled guilty to a crime? yes no Is yes, explain:
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EDUCATION: Name Years Degree/Diploma
High School:
GED Equivalent:
Trade/Tech:
College:
Other:
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EXPERIENCE:
Company Name: Supervisor Name:
Phone: Company Address:
Date Started: Date Ended:
What were your duties? Reason for leaving?
Starting Pay?: Ending Pay?:
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Company Name: Supervisor Name:
Phone: Company Address:
Date Started: Date Ended:
What were your duties? Reason for leaving?
Starting Pay?: Ending Pay?:
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Company Name: Supervisor Name:
Phone: Company Address:
Date Started: Date Ended:
What were your duties? Reason for leaving?
Starting Pay?: Ending Pay?:
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REFERENCES: Name Phone
Reference #1:
Reference #2:
Reference #3:
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Are there any physical limitations that may impair you from performing the duties of a cleaner/janitor? yes no