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Fill out our application to join our awesome team!

If you are interested in working with us, please fill out the application below. Thank you, and looking forward to reviewing your application.

Application Information

Name:

Email:

Phone:

Address

Date Available

SSN:

Desired Salary:

Position Applied For:

Carpet Crew Member

Carpet Cleaner

Are you a citizen of the United States"

Yes

No

Have you Ever Worked for this Company:

Yes

No

If no, are you authorized to work in the U.S.?

If yes, when?

Have you ever been convicted of a felony?

Yes

No

If yes, explain:

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Education

High School:

College:

From

To:

From:

To:

Did you graduate?

Yes

No

Degree:

Did you graduate?

Yes

No

Degree:

Address:

Other:

Level of education completed

Some High School

Complete High School

Some College

Associate's Degree

Bachelor's Degree

Master's Degree

PhD

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References

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Please list three professional references

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Reference 1:

Name:

Phone Number:

Company:

Address:

Relationship:

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Reference 2:

Name:

Phone Number:

Company:

Address:

Relationship:

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Reference 3:

Name:

Phone Number:

Company:

Address:

Relationship:

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Previous Employment

Company:

Phone Number:

Name:

Address:

Supervisor:

Responsibilities:

Job Title:

Reason for leaving:

Starting Salary:

Ending Salary:

From:

To:

May we contact your supervisor for a reference?

Yes

No

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Company:

Phone Number:

Name:

Address:

Supervisor:

Responsibilities:

Job Title:

Reason for leaving:

Starting Salary:

Ending Salary:

From:

To:

May we contact your supervisor for a reference?

Yes

No

Company:

Phone Number:

Name:

Address:

Supervisor:

Responsibilities:

Job Title:

Reason for leaving:

Starting Salary:

Ending Salary:

From

To:

May we contact your supervisor for a reference?

Yes

No

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Military Service

Branch:

Rank at Discharge:

From:

To:

Type of discharge:

if other than honorable, explain:

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Disclaimer and signature

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I certify that my answers are true and complete to the best of my knowledge.

If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.

Electronic Signature:

Today's Date:

Thank you for contacting us.
We will get back to you as soon as possible.

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J's Cleaning Service LLC

3303 Airline Blvd. Suite 3H

Portsmouth, VA 23701

888-511-9177

jcleaning.service@yahoo.com

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