THRIFTY MAID APPLICATION FOR EMPLOYMENT

(PRE-EMPLOYMENT QUESTIONAIRE) - (AN EQUAL OPPORTUNITY EMPLOYER)

PERSONAL INFORMATION

LAST NAME

FIRST NAME

MIDDLE NAME

STREET ADDRESS

CITY

STATE

ZIP CODE

PHONE NUMBER

EMAIL

ARE YOU 18 YEARS OR OLDER? Yes No

ARE YOU EITHER A U.S. CITIZEN OR AN ALIEN AUTHORIZED TO WORK IN THE USA? Yes No

ARE YOU CAPABLE OF PERFORMING THE ACTIVITIES FOR THE POSITION YOU ARE APPLYING? Yes No

HAVE YOU BEEN CONVICTED, OR HAVE PENDING, A FELONY OR MISDEMEANOR OTHER THAN TRAFFIC VIOLATION? Yes No

EDUCATION

HIGH SCHOOL

NAME/LOCATION OF SCHOOL

YEARS ATTENDED

DID YOU GRADUATE Yes No

COLLEGE

NAME/LOCATION OF SCHOOL

YEARS ATTENDED

DID YOU GRADUATE Yes no

FORMER EMPLOYERS (LIST BELOW LAST TWO EMPLOYERS, STARTING WITH LAST ONE FIRST)

Employer 1

MONTH/YEAR

NAME OF EMPLOYER

ADDRESS OF EMPLOYER

POSITION

SALARY

REASON FOR LEAVING

Employer 2

MONTH/YEAR

NAME OF EMPLOYER

ADDRESS OF EMPLOYER

POSITION

SALARY

REASON FOR LEAVING

EMPLOYMENT DESIRED

POSITION

START DATE

DESIRED SALARY

DAYS/HOURS YOU CAN WORK

IN CASE OF AN EMERGENCY NOTIFY

NAME

ADDRESS

PHONE NUMBER

I CERTIFY THAT THE FACTS CONTAINED IN THIS APPLICATION ARE TRUE AND COMPLETE TO THE BEST OF MY KNOWLEDGE AND UNDERSTAND THAT, IF EMPLOYED OR CONTRACTED, FALSIFIED STATEMENTS ON THIS APPLICATION SHALL BE GROUNDS FOR DISMISSAL.

INFORMATION CONCERNING MY PREVIOUS EMPLOYMENT AND ANY PERTINENT INFORMATION THEY MAY HAVE, PERSONAL OR OTHERWISE, AND RELEASE ALL PARTIES FROM ALL LIABL1TY FOR ANY DAMAGE THAT MAY RESULT FROM FURNISHING SAME TO YOU.

I UNDERSTAND AND AGREE THAT, IF HIRED OR CONTRACTED WITH, MY EMPLOYMENT/CONTRACT IS FOR NO DEFINITE PERIOD AND MAY, REGARDLESS OF THE DATE OF PAYMENT OF MY WAGES, BE TERMINATED AT ANY TIME WITHOUT PRIOR NOTICE.

I Agree

Date

A Thrifty Maid, Professional Cleaning Service

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Residential
Commercial
Estimate
Application

Tampa
FL
33618

tbingham@athriftymaid.com
Phone: (813) 404-5009