EMPLOYMENT APPLICATION HOME // EMPLOYMENT APPLICATION We Need Cleaning Professionals!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. Please enable JavaScript in your browser to complete this form._____________________________________________________________________________________________________________________________________________Application Date *** Today's DateName *FirstLastAddress Line 1 *Address Line 2City *State *MassachusettsConnecticutZip Code *Date of Birth *Daytime Phone Number *Daytime Phone NumberEmail *Your Email AddressHow did you hear about us?Are you legally eligible to work in the U.S.? *YesNoAre you willing to take a drug test? *YesNoDo you have a valid driver's license? *YesNo_____________________________________________________________________________________________________________________________________________EMPLOYMENT HISTORYPlease list your 2 most current work history/experience_____________________________________________________________________________________________________________________________________________Company Name (Most Current) *Job Title *Dates of Employment *Reason for Leaving *_____________________________________________________________________________________________________________________________________________(2) Company Name *Job Title *Dates of Employment *Reason for Leaving *_____________________________________________________________________________________________________________________________________________Do you have any prior cleaning experience? *YesNo>> If yes, explain briefly:Are you comfortable working around pets? *YesNoCan you lift 25+ pounds and be on your feet for extended periods? *YesNoDo you have reliable transportation to get to jobs?YesNoWhat days and times are you available to work? (Check all that apply) *Monday AMMonday PMTuesday AMTuesday PMWednesday AMWednesday PMThursday AMThursday PMFriday AMFriday PMSaturday AMSaturday PMSunday AMSunday PMWhy do you want to work for LesleyLola Cleaning Service? *Do you have any criminal convictions we should be aware of? (Disclosure does not automatically disqualify you.) *_____________________________________________________________________________________________________________________________________________ReferencesPlease list 1-2 professional references (no family members.)(1) Name *(1) Relationship *(1) Phone Number *(2) Name *(2) Relationship *(2) Phone Number *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 Lesley Lola Cleaning Service®, 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 Lesley Lola Cleaning Service® policies, rules, and procedures. I understand that Lesley Lola Cleaning Service® 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 never been convicted of a felony and I have no criminal charges pending against me. _____________________________________________________________________________________________________________________________________________Type Signature *Submit
