February 25, 2018 Effingham Office Maids Employment Application Order Number Full Name * Email Address * Date of Birth * Phone Number * Alternate Phone Number * Home Address * Previous Employer #1 Title & Responsibilities? Start Date? End Date? Reason For Leaving? Previous Employer #2 Title & Responsibilities? Start Date? End Date? Reason For Leaving? Previous Employer #3 Title & Responsibilities? Start Date? End Date? Reason For Leaving? What Are 3 Words You Would Use to Describe Yourself? * How many Years Of Cleaning Experience Do You Have? * What Kind Of Cleaning Have You Done? Explain. * Your 3 References. Names & Phone Numbers. * Tell Us Why You Think You Would Make a Great Addition To Our Team. * Type each new reference on a new line Do You Have Reliable Transportation? * Yes No Do you Have A Valid Drivers Licence? * Yes No Will You Consent To A Background Check & Drug Test? * Yes No Includes Criminal and driving record as well.