Cleaning Housekeeping Service Job Application Form

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.
E-mail *
Application Date *

Month Day Year
Full Name *

First Name Last Name
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Day Time Phone *

Area Code Phone Number
How did you hear about us?
If you are referred by a person, please submit name and last name below:

First Name Last Name
Date You Are Available to To Start Working *

Month Day Year
Do You Have Previous Housekeeping or Residential Cleaning Experience? *

Yes No
Are You Legally Eligible to Work in the U.S.? *

Yes No
Are You at Least 18 Years Old? *

Yes No
Are You Able to Pass a Background Check? *

Yes No
Do you have a valid driver's license? *

YES NO
Do you have reliable transportation? *

YES NO
Do you have a smartphone? *

YES NO
How Many Hours Per Week Would You Like to Dedicate Working for CleanUp? *

0-10 10-20 20-30 30-40 40+
What Days Are You Most Interested in Working? (Mark all that apply) *

Monday Tuesday Wednesday Thursday Friday Saturday Sunday
What Times of Day Are You Most Interested In Working? *

Mornings Afternoons Evenings
WORK STATUS/ REFERENCES

Please list your current employer, if applicable, and 3 non-related references
Are you currently employed somewhere? *

YES NO
Employer's Name
Position Held
Supervisor's Name
Telephone

Area Code Phone Number
Start Date

Month Day Year
May we contact this employer? (please check one)

YES NO
If NO, reason why not
Are you planning to stay with your current employer while working at CleanUp?

YES, I plan to keep my current job while working at CleanUp NO, I intend to use CleanUp as my only source of income
We DO NOT consider OR interview anyone who cannot provide 3 references (work, education or personal). NO FAMILY MEMBERS.
Reference (1) Name *
Reference (1) Telephone *

Area Code Phone Number
E-mail
example@example.com
Reference (2) Name *
Reference (2) Telephone *

Area Code Phone Number
E-mail
example@example.com
Reference (3) Name *
Reference (3) Telephone *

Area Code Phone Number
E-mail
example@example.com
OTHER QUESTIONS
How would you describe your cleaning habits? *

Clean Freak! Pretty Tidy Don't care too much about cleaning but don't mind doing it
How do you feel about being your own boss and managing your own schedule? *

My ultimate professional goal and I am sure I can be good at it Sounds good but I am not sure if i can be good at it I work better with the support of a management team/leader
What are your views on customer services and getting excellent reviews? *

My number one priority Important but not a priority Don't really care/know much about it, I can benefit from some guidance on this topic
What is the procedure in general for cleaning any room in a house? *

Work your way in a circle cleaning everything, top to bottom, as you go Clean up to down working your way around so not to miss anything Clean the more difficult areas first and the easier areas last
What would you do if there was a $20 bill laying on a table with no note? *

Take the money as a tip Ask the client if it is meant for you Leave it where it is. You don't know if it was meant for you
Do you have or are you able to acquire your own cleaning products and equipment before being placed on the registry? *

Yes, I already have my own equipment and supplies No, but I am acquiring my own equipment and supplies before being placed on the registry No, I don't have any equipment and/or supplies
If you answered yes to the question above, please mark the cleaning tools you have available to complete a cleaning job: *

Broom Dust Pan Mop Bucket Vacuum Toilet Brush Spray Bottles Scrub Brushes Sponges/rags I don't have any cleaning tools
Click Here to Upload Your Resume (optional)
Type Signature *
Enter the message as it's shown *
If other please specify:
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We Need Cleaning Professionals!

WORK STATUS/ REFERENCES

We DO NOT consider OR interview anyone who cannot provide 3 references (work, education or personal). NO FAMILY MEMBERS.

OTHER QUESTIONS