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Rise & Shine Cleaning of Indiana, Inc

Employment Application

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PRE-EMPLOYMENT QUESTIONNAIRE

EQUAL OPPORTUNITY EMPLOYER

Please fill out the form below.  Fields marked with an * are required.

First Name  
Last Name  
Street Address  
Address (cont.)  
City  
State/Province  
Zip/Postal Code  
Day Phone  
Evening Phone  
Cell Phone  
E-mail  
How did you hear about Rise & Shine Cleaning?  

Availability
Are you interested in FT or PT? Full Time Part Time
Total hours available per week?
What days are you available? Mon TuesWedThursFriSat
Tell us a little about what you do now.
Why is this job for you?
Do you have an specific questions?
Have you ever been convicted of a felony or a crime involving dishonesty? Yes No
Have you ever had a drivers license suspended , revoked or been convicted of a DUI or DWI? Yes No
If yes please list the date, County, State and type of conviction

Please list the names of three references not related to you whom you have known at least five years

Name  
Phone  
Years Known  
Name  
Phone  
Years Known  
Name  
Phone  
Years Known  

 

Thank you!!