Name

Primary Phone

Street Address

City

State

Zip Code

Email

Are you at least 21 years old? Are you at least 21 years old? Yes No

Have you ever been convicted of a felony? Have you ever been convicted of a felony? Yes No

Do you have a valid drivers license? Do you have a valid drivers license? Yes No

Do you have reliable transportation? Do you have reliable transportation? Yes, I own a car. Yes, I use public transportation. No

How many hours a week are you available to work? How many hours a week are you available to work? Part Time 1-10 hours Part Time 10-20 hours Part Time 20-29 Hours Full Time

What time frames are you available to work? What time frames are you available to work? Mornings 5am-1pm Mid day 1pm-7pm Late Night 7pm-2am

When are you available to start? When are you available to start? As soon as possible 1-2 weeks 2-4 weeks

Do you have any experience in commercial cleaning? Do you have any experience in commercial cleaning? Yes, I'm very experienced. Somewhat No

What cities are you available to work? What cities are you available to work?Cleveland- DowntownCleveland- East SideCleveland- West SideLake CountyLorain CountySummit CountyMedina CountySandusky

Work History: List last 3 employers and dates employed

Any additional information you want us to consider