Job Application Interested in working with Efficiency Cleaning Service? Fill out the application below and we’ll be in touch! Personal InformationName(Required) First Last Do you have a valid social security card?(Required) Yes No Do you have a valid driver's license?(Required) Yes No Do you have valid auto insurance?(Required) Yes No Do you have any restrictions for (check all that apply):(Required) Lifting over 25-50 lbs Climbing a ladder Cleaning on hands and knees None of the above Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Phone(Required)Email(Required) Additional InformationDate of Birth (You must be 18 years old to apply)(Required) MM slash DD slash YYYY Are you eligible for employment in the United States?(Required) Yes No Primary language spoken:(Required) English Spanish Other When can you start?(Required) MM slash DD slash YYYY Are you currently employed?(Required) Yes No Do you have reliable transportation?(Required) Yes No EducationName and Address of High School(Required)Did you graduate?(Required) Yes No Name and Address of CollegeField of StudyDid you graduate? Yes No Do you have any other education, certifications or military training you'd like us to know about?Most Recent EmployerName and Address of Employer(Required)Start Date(Required) MM slash DD slash YYYY End Date (leave blank if currently employed) MM slash DD slash YYYY Position(Required)Salary(Required)Reason for Leaving(Required)Name of Supervisor(Required) First Last Supervisor Phone Number(Required)Second-Most Recent EmployerName and Address of Employer(Required)Start Date(Required) MM slash DD slash YYYY End Date (leave blank if currently employed) MM slash DD slash YYYY Position(Required)Salary(Required)Reason for Leaving(Required)Name of Supervisor(Required) First Last Supervisor Phone Number(Required)ReferencesProvide three persons not related to you that you have known at least one year.Reference #1 Name(Required) First Last Reference #1 Phone(Required)Reference #2 Name(Required) First Last Reference #2 Phone(Required)Reference #3 Name First Last Reference #3 PhoneAdditional InformationWhat made you want to apply for this job?(Required)Have you ever been convicted of a felony or misdemeanor? (other than misdemeanor traffic violations)*(Required) Yes No If yes, please explainAuthorization(Required) I have read and agree to the authorization statement below.I CERTIFY THAT THE FACTS CONTAINED IN THIS APPLICATION ARE TRUE AND COMPLETE TO THE BEST OF MY KNOWLEDGE AND UNDERSTAND THAT, IF EMPLOYED, FALSIFIED STATEMENTS ON THIS APPLICATION SHALL BE GROUNDS FOR DISMISSAL. I AUTHORIZE INVESTIGATION OF ALL STATEMENTS CONTAINED HEREIN AND THE REFERENCES AND EMPLOYERS LISTED ABOVE TO GIVE YOU ANY AND ALL INFORMATION CONCERNING MY PREVIOUS EMPLOYMENT AND ANY PERTINENT INFORMATION THEY MAY HAVE, PERSONAL OR OTHERWISE, AND RELEASE THE COMPANY FROM ALL LIABILITY FOR ANY DAMAGE THAT MAY RESULT FROM UTILIZATION OF SUCH INFORMATION. I ALSO UNDERSTAND AND AGREE THAT NO REPRESENTATIVE OF THE COMPANY HAS ANY AUTHORITY TO ENTER INTO ANY AGREEMENT FOR EMPLOYMENT FOR ANY SPECIFIED PERIOD OF TIME, OR TO MAKE ANY AGREEMENT CONTRARY TO THE FOREGOING, UNLESS IT IS IN WRITING AND SIGNED BY AN AUTHORIZED COMPANY REPRESENTATIVE.
