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Full Name:

Phone Number:

Email Address:

Address (City, State, ZIP):

Preferred Method of Contact:

Phone

Email

1. Do you have cleaning experience?

Yes

No

2. Can you work mornings, evenings, or weekends?

Yes

No

3. Do you have reliable transportation?

Yes

No

4. Can you lift 50 pounds?

Yes

No

5. Are you okay with physical work like standing, bending, or kneeling?

Yes

No

6. Can you use cleaning equipment (like vacuums or floor scrubbers)?

Yes

No

7. Are you willing to have a background check?

Yes

No

8. What days can you work?

9. Why do you want this job?

10. Anything else we should know?

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