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Home About Us Associates Work Opportunities General Cleaning List Get an Estimate Contact Apply for work opportunities Personal information ---- Mr. Mrs. Miss Ms. First name: MI: Last Name: Street Address: Apt or Unit#: City: State AL AK AZ AR CA CO CT DC DE FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WI WV WY Zip: Email Address: Home phone: Cell phone: Social Security Number (You must have one to work with us): Personal status Are you currently employed? yes no If hired, when are you available to start? Jan Feb Mar Apr May Jun Jul Aug Sept Oct Nov Dec 12345678910111213141516171819202122232425262728293031 200720082009 Do you own a car? yes no What year is it? Year 20082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959 Do you have a backup car to use? yes no What year is it? Year 20082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959 Are you over 18? yes no If no, do you have a work permit? yes no Do you have a criminal record? yes no If so, please describe: Availability Monday from: 6 7 8 9 10 11 12 1 2 3 4 5 6 00 15 30 45 to: 6 7 8 9 10 11 12 1 2 3 4 5 6 00 15 30 45 Tuesday from: 6 7 8 9 10 11 12 1 2 3 4 5 6 00 15 30 45 to: 6 7 8 9 10 11 12 1 2 3 4 5 6 00 15 30 45 Wednesday from: 6 7 8 9 10 11 12 1 2 3 4 5 6 00 15 30 45 to: 6 7 8 9 10 11 12 1 2 3 4 5 6 00 15 30 45 Thursday from: 6 7 8 9 10 11 12 1 2 3 4 5 6 00 15 30 45 to: 6 7 8 9 10 11 12 1 2 3 4 5 6 00 15 30 45 Friday from: 6 7 8 9 10 11 12 1 2 3 4 5 6 00 15 30 45 to: 6 7 8 9 10 11 12 1 2 3 4 5 6 00 15 30 45 What is the minimum number of hours you would like to work? -- 10 or less at least 10 20 or less at least 20 30 or less at least 30 40 or less at least 40
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