Peeples Professional Cleaning

Today's Date

Email*

Name*

Current Address*

Street Address City State ZIP Code

Phone

If under 18, please list age

Position Applied For:*

Date Available*

How many hours can you work weekly?*

Can you work nights?

Yes
No

Days/Hours

Monday

Available

Number of hours

Tuesday

Available

Number of hours

Wednesday

Available

Number of hours

Thursday

Available

Number of hours

Friday

Available

Number of hours

Saturday

Available

Number of hours

Sunday

Available

Number of hours

HAVE YOU EVER BEEN CONVICTED OF A CRIME?*

Yes
No

If yes, explain number of conviction(s), nature of offense(s) leading to conviction(s), how recently such offense(s) was/were committed, sentence(s) imposed, and type(s) of rehabilitation.

Do you give consent for Peeples Professional Cleaning Service to conduct a criminal background check?*

Yes
No

DO YOU HAVE A DRIVER'S LICENSE?*

Yes
No

What is you means of transportation to work?*

Have you had any accidents during the past three years?*

Yes
No

How many?

Have you had any moving violations during the past three years?*

Yes
No

How many?

EMPLOYMENT HISTORY

List complete employment history, including self-employment and periods of unemployment, from most recent to least.

EMPLOYMENT 1

Employer

Date Employed From (Mo./Yr.):

Date Employed To (Mo./Yr.):

Starting Position

Last Position

Other Position

Address

Street Address City State ZIP Code

Phone

Last Supervisor:

Duties in position:

Starting Salary/Wage:

Final:

Reason for Leaving:

EMPLOYMENT 2

Employer

Date Employed From (Mo./Yr.):

Date Employed To (Mo./Yr.):

Starting Position

Last Position

Other Position

Address

Street Address City State ZIP Code

Phone

Last Supervisor:

Duties in position:

Starting Salary/Wage:

Final:

Reason for Leaving:

EMPLOYMENT 3

Employer

Date Employed From (Mo./Yr.):

Date Employed To (Mo./Yr.):

Starting Position

Last Position

Other Position

Address

Street Address City State ZIP Code

Phone

Last Supervisor:

Duties in position:

Starting Salary/Wage:

Final:

Reason for Leaving:

EMPLOYMENT 3

Employer

Date Employed From (Mo./Yr.):

Date Employed To (Mo./Yr.):

Starting Position

Last Position

Other Position

Address

Street Address City State ZIP Code

Phone

Last Supervisor:

Duties in position:

Starting Salary/Wage:

Final:

Reason for Leaving:

EMPLOYMENT 4

Employer

Date Employed From (Mo./Yr.):

Date Employed To (Mo./Yr.):

Starting Position

Last Position

Other Position

Address

Street Address City State ZIP Code

Phone

Last Supervisor:

Duties in position:

Starting Salary/Wage:

Final:

Reason for Leaving:

EMPLOYMENT 5

Employer

Date Employed From (Mo./Yr.):

Date Employed To (Mo./Yr.):

Starting Position

Last Position

Other Position

Address

Street Address City State ZIP Code

Phone

Last Supervisor:

Duties in position:

Starting Salary/Wage:

Final:

Reason for Leaving:

EMPLOYMENT 6

Employer

Date Employed From (Mo./Yr.):

Date Employed To (Mo./Yr.):

Starting Position

Last Position

Other Position

Address

Street Address City State ZIP Code

Phone

Last Supervisor:

Duties in position:

Starting Salary/Wage:

Final:

Reason for Leaving:

Email

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Job Application

Days/Hours

EMPLOYMENT HISTORY

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