Employment Application | National Cleaning LLC

Name *
Name Called By Company * Email *

Address Street Address* Street Address Line 2 City * State / Province * Postal / ZIP Code *

Years At This Address Phone Number *
Area Code Phone Number Social Security Number Date Available To Work

Have you ever been employed by us? * Yes No If yes, when and where?

Do you have a legal right to work permanently in the U.S.? * Yes No If no, explain?

Have you ever been convicted of felonies? * Yes No If yes, explain?

Type of position/function desired

Educational Background Years Completed Did you graduate? Yes No Course Of Study Highschool College

List the past three address of with you have lived in the past ten years.
Start with current. 1 2 3

Employment History- 1 Job Title Employer Address Immediate supervisor and title: Work performed and responsibilities: Reason for leaving Telephone Hourly rate/salary

Any additional comments regarding position held?

BUSINESS/PERSONAL REFERENCE Name Occupation Address Phone Number

Summary of janitorial experience, if any. Experience Equipment List any training received that would aid you in the position you are applying for:

ACTIVITIES AND HOBBIES Let us know about your hobbies and activities of interest: Please list any physical or medical limitation that may not be compatible with the job you are applying for.

By signing this application, I certify: That this application is complete and accurate to the best of my knowledge and that I have not made any attempt to conceal information that falsification could be cause for dismissal. National Cleaning Services, Inc. or its agents may request employment information from my previous employers and persons or corporations who provide information related to my previous employment and will be released from any liability or damage. Also, I agree if required to undergo a medical examination by a company designated physician and understand that medical approval must be obtained before employment can be effected. I have noted that National Cleaning Services, Inc. is an Equal Opportunity Employer and applicants receive lawful consideration for employment without regard to Race, Religion, Color, Sex, Age, National origin, Disability, or Veteran Status. I understand that just as I am free to resign at any time, the employer reserves the right to terminate employment at will. I understand that no representative of the Employer has the authority to make any assurances to the contrary. I agree that all clients, cleaning techniques and operational procedures to which I gain access to are confidential trade secrets of National Cleaning Services, Inc., and shall not be revealed to any third parties. I further understand that if I divulged any confidential information or attempt to gain employment or retain accounts directly with any of National Cleaning Services clients, I am subject to legal action that may include me paying financial damages to National Cleaning Services, Inc.

Signature Print Name date

EMPLOYMENT SUBJECT TO: Passing physical examination/drug specimen by company designated physician. Satisfactory reference reports Favorable reports from outside agencies on verification of information supplied

Let's Clean Together

APPLICATION FOR EMPLOYMENT