Cozgroovy Green Cleaning
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Personal Information
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| Name
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| Prefix
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| Are you legally eligible to work in the United States?
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Yes No
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POSITION/AVAILABILITY:
You are applying for the position of Cleaning Technician. Our part-time positions consist of 20-30 hours per week.
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| Days Available
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Monday Tuesday Wednesday Thursday Friday Any
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| Hours Available
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AM PM For specific Day/Hour availability, please enter information below.
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| What date are you available to start work?
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| How did you hear about this position?
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EMPLOYMENT HISTORY:
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| Hourly Rate/Salary
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| Reason you are considering new employment:
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| May We Contact This Employer?
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Yes No
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Previous Position
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| Reason for Leaving:
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| May We Contact This Employer?
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Yes No
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SPECIAL SKILLS AND QUALIFICATIONS:
What skills or training do you have that you could bring to a cleaning position
with our company?
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| Please tell us a little about yourself or provide any questions and/or comments you may have.
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BONDING
A Background Check will be done on all employees.
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| Have you ever been convicted of any crimes? Include Felony, Misdemeanor, or other offenses.
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Yes No
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| If yes, list all convictions with years committed, circumstances, and outcome(s).
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TRANSPORTATION
Cozgroovy Green Cleaning provides service throughout the City of Madison and its surrounding suburbs.
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| Do you have a valid driver's license?
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Yes No
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| Do you have liability insurance on your vehicle?
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Yes No
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| Do you have full-time access to a vehicle?
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Yes No
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I certify that answers given herein are true and complete. I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision.
In the event of employment, I understand that false, misleading or omitted information given in my application or interview(s) is cause for immediate dismissal. I understand, if hired, that I am required to abide by all Company rules and regulations.
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| Do you agree with the terms and conditions?
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Yes, I agree.
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| Initial
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| Date
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