Employment

Please complete the form below

Name

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

Email Address

Social Security Number

Have you ever been convicted of a felony?

If yes, please explain.

Desired Hourly Rate

Do you have prior cleaning experience?

What makes you a good candidate for this type of work?

CURRENT EMPLOYER

Start Date:

Name of Employer

Address of Employer

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Wage

Reason for leaving

Position

FORMER EMPLOYER 1

Dates Worked

Name of Employer

First Name

Last Name

Address of Employer

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Position

Wage

FORMER EMPLOYER 2

Dates Worked

Name of Employer

Position

Wage

Reason for leaving

REFERENCES

Give the names of three persons not related to you, whom you have known at least one year.

First Name

Last Name

Phone 1

(###)

###

####

Reference #2

First Name

Last Name

Phone 2

(###)

###

####

Reference #3

First Name

Last Name

Phone 3

(###)

###

####

Additonal Remarks

Employment

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Reinholz Professional Cleaning Services is a fully insured, licensed, and bonded company. All employees are BCI and FBI background checked.