Apply Apply BelowFill out as accurately as possible. Fields marked with an * are required! Order Number First Name * Last Name * Email Address * Date * Street Adress or P.O. Box * City * State * - Select Province/State - Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Nova Scotia Northwest Territories Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon ==================== Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip Code Primary Phone * Secondary Phone Number Emergency Contact Name * Emergency Contact Number * Emergency Contact Relationship Date You're Available * Are you under the age of 18? * Yes No Do you have a valid driver's license? * Yes No Do you have a valid vehicle registration? * Yes No According to the Massachusetts Reference Chart Regarding Permissible Inquiries, 3.02: Once an offer of employment has been made, an employer may condition that offer on the results of a medical examination conducted soley for the purpose of determining whether the employee, with or without reasonable accommodation, is capable of performing the essential functions of the job. ( A doctors note would be permissible indicating you are able to do physical labor consisting of lifting bending and carrying vacuums upstairs in a work day up to six hours.) Yes No Are you in agreement with this inquiry? Are you a citizen of the United States? * Yes No Education What is your level of Education? High School High School College College High School and address; Dates Attended; Did you Graduate? Yes No Do you have any other Education? Yes No T.L.C. Home Cleaning has a Zero-Tolerance policy on theft and that any employee including Management Leaders, who violates this policy, will be terminated immediately. We will then report such incidents to the proper authorities and a full investigation will be conducted for restitution and/or prosecution. * Yes No Do you agree to the above statement? Please Submit your work history or resume. Add File Please upload your resume in PDF format. Previous Employment Company #1 * Their Number * Address * Supervisor * Job Title * Starting Salary * Ending Salary * Responsibilities You worked there from what date to what date? * Get it as accurate as you can. Reason for Leaving * May we contact your previous supervisor for reference? * Yes No Company #2 * Their Number * Address * Supervisor * Job Title * Starting Salary * Ending Salary * Responsibilities You worked there from what date to what date? * Get it as accurate as possible. Reason for Leaving * May we contact your previous supervisor for reference? * Yes No Military Service Have you ever served in the Military? * Yes No Additional Info What time can you start work in the morning? * What time do you need to be home by in the afternoon? * Are you available for evenings? * Yes Usually Sometimes No Almost Never Are there days that you cannot work? * Can you work Saturdays? * (We do require all employees to work two Saturdays a Month during Spring/Fall Cleanings or if there is an increase in job volume) Is your car a 4 or 6 cylinder? 4 6 Other Not Sure It is very important to have someone to care for your school aged children if they are sick during snow days and vacations. If you require childcare, you will need at least two dependable sitters incase one cancels out on you. Do you have two dependable sitters? * Yes No Do you have any allergies to pets? * Yes No Do you have any fear of animals? * Do you consider yourself dependable and punctual? * Is there anything we show know about? We supply all cleaning products. New employees will start at $13.00 per hour and will be working with a management team leader for 30 days. At the end of the 30 days, the supervisor will collect all assessments from the management team and schedule a time for you to receive your performance evaluation. At that time, it will be determined whether you have demonstrated a thorough understanding of the job, are dependable and capable of handling assigned clients. Once that has been determined then you would be promoted and given assigned clients. Your training officially ends on your 90 days in which you would be elevated to $14.00 per hour. At your 90 days, you are entitled to use Paid Time Off. In addition, at your 90 days review you may inquire about a management position. Your review will help me to determine whether you are teachable, dedicated to the company, a team player, and can go above and beyond for our clients! For the most part, employees will be working by themselves after the training period, unless we have special jobs such as Spring or Fall cleanings. Quality control checks are done periodically. My employees are expected to be flexible: to join others in doing these larger jobs. At T.L.C. Home Cleaning, we are a team! Everyone has a different way of cleaning; however, I am looking for someone that can clean thoroughly, efficiently and takes direction. We are a professional cleaning company that is extremely detailed. My staff is required to work at least two Saturday's monthly during our Spring and Fall cleaning season. We will compensate for traveling to any job after the first client in the same day according to the sites of Mapquest/Gogglemaps. * Yes No Do you agree to this statement? Information Summary I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false and misleading information in my application and/or interview may result in my termination. I, the applicant for this Employment Application, warrant the truthfulness of the information provided in this application. Your Full Name * Date * Disclaimer I understand that checking this box constitutes a legal signature confirming that I acknowledge and agree to the above Terms of Acceptance.