Applicant Information
* Required Fields
Last Name: *
First Name : *
Middle Initial *
Address: *
Apartment/Unit # *
State: *
Zip Code: *
Phone: * (No spaces)
E-mail Address : *
Date Available * MM/DD/YY
Social Security No.: *
Desired Salary: $ *
Position Applied for: *
Are you a citizen of the United States? Yes. No. *
If no, are you authorized to work in
the U.S. ? 		Yes. No. *
Have you ever worked for this company? Yes. No. *
If yes, when? * MM/DD/YY
Have you ever been convicted of a felony? Yes No. *
If yes, explain: *
   
Education  
   
High School:
Address:
From: MM/YY
To: MM/YY
Did you graduate? Yes. No.
Degree:
   
College:
Address:
From: MM/YY
To: MM/YY
Did you graduate? Yes. No.
Degree:
   
Other:
Address:
From: MM/YY
To: MM/YY
Did you graduate? Yes. No.
Degree:
   
 
   
References  
   
Please list 2 Professional References  
   
Full Name:
Relationship:
Company:
Phone: (No spaces)
   
Full Name:
Relationship:
Company:
Phone: (No spaces)
   
Previous Employment  
   
Company:
Phone: (No spaces)
Address:
Supervisor:
Job Title:
Starting Salary: $
Ending Salary: $
Responsabilities
From: MM/YY
To: MM/YY
Reason for leaving:
May we contact your previous supervisor for a reference? Yes. No.
   
Company:
Phone: (No spaces)
Address:
Supervisor:
Job Title:
Starting Salary: $
Ending Salary: $
Responsabilities
From: MM/YY
To: MM/YY
Reason for leaving:
May we contact your previous supervisor for a reference? Yes. No.
   
 
   
Experience  
   
Cleaning:
From: MM/YY
To: MM/YY
   
Stripping Floors :
From: MM/YY
To: MM/YY
   
Buffing Floors:
From: MM/YY
To: MM/YY
   
Waxing Floors:
From: MM/YY
To: MM/YY
   
Window Cleaning :
From: MM/YY
To: MM/YY
   
Restroom Cleaning :
From: MM/YY
To: MM/YY
   
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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.
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Signature  
Last Name: *
First Name: *
Date: * MM/DD/YY
 
 

 

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COPYRIGHT 2010 - NORTH SHORE CLEAN Cleaning Services
Coverage Area Includes: Andover MA, Beverly MA, Danvers MA, Gloucester MA, Hamilton MA, Ipswich MA, Lynnfield MA, Peabody MA, Middleton MA, Salem MA, Swampscott MA, Topsfield MA