Job Application

Personal Information

Name
Prefix
First
Last
Suffix
Phone Number

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Birthday
Address
City, State
Are you married or single?
Do you have Children? If so, please list ages.
Do you smoke?
Do you have any allergies, asthma, back pain or anything else that would interfier with this work? If so please explain.
Do you have any cleaning expericance, if so give details.
How many Hours a week are you looking for?
Days Available
 Monday 
 Tuesday 
 Wednesday 
 Thursday 
 Friday 
 Saturday 
 Any 
Hours Available
 AM 
 PM 
 Graveyard 
What would make you the BEST for this position. What do you have to offer to Allred's Amazing Maids Inc.? Why should I pick you?
What date are you available to start work?

MM
/
DD
/
YYYY

EDUCATION:

Please list your highest level of education, and if you did or did not graduate.
Name Of School - Did you Graduate? Graduation Date

EMPLOYMENT HISTORY:

Please list you past three employees starting with the most recent or current employer.
Employer:
City, State
Supervisor:
Phone Number

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Position Title:
Are you currently employed with this employer?
If so, may we contact Your Present Employer?
 Yes 
 No 
Start Date

MM
/
DD
/
YYYY
End Date

MM
/
DD
/
YYYY
Responsibilities:
Salary
Input hourly wage, if not salaried.
Reason for Leaving:

Previous Position
Employer:
City, State
Supervisor:
Phone Number

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-
###
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####
Position Title:
Start Date

MM
/
DD
/
YYYY
End Date

MM
/
DD
/
YYYY
Responsibilities:
Salary
Input hourly wage, if not salaried.
Reason for Leaving:
What is your five year plan?
Professional Reference and #
Professional Reference and #

I certify that information contained in this application is true and complete. I understand that false information may be grounds for not hiring me or for immediate termination of employment at any point in the future if I am hired. I authorize the verification of any or all information listed above.
Do you agree with the terms and conditions? *
 Yes, I agree. 
Date

MM
/
DD
/
YYYY
Email
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