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Preliminary Job Application
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Name
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We receive hundreds of applications. Why should we hire you?
Please continue --->
When can you start?
Drivers License #
State issued?
Years licensed?
Are you willing to drive for us?
Yes
No
Moving violations in the last 5 years?
Yes
No
If Yes to above, give details:
Has your license EVER been suspended or revoked?
Yes
No
If yes to above, why?
Please continue --->
Have you ever been convicted of a misdemeanor or felony?
Yes
No
If yes, details please.
Do you give Executive Maids permission to run a Criminal History Check prior to hiring you and periodically after hiring?
Yes
No
Are you willing to take a drug test before we hire you and periodically unannounced?
Yes
No
Are you afraid of or allergic to animals?
Yes
No
Do you have any physical problems that would prevent you from doing the job as described above?
Yes
No
If yes, please list your medical conditions.
Cont. to Job History --->
Name of Company
Phone number
Company address
City
State
Zip Code
Job title/duties
Official Supervisor
Employed from (mm/dd/yyy)
Employed to (mm/dd/yyy)
Reason for leaving
# hours worked per week
Pay rate
May we call this employer?
Yes
No
Employer #2 -->
Name of Company
Phone number
Company address
City
State
Zip Code
Job title/duties
Official Supervisor
Employed from (mm/dd/yyy)
Employed to (mm/dd/yyy)
Reason for leaving
# hours worked per week
Pay rate
May we call this employer?
Yes
No
Employer #3 -->
Name of Company
Phone number
Company address
City
State
Zip Code
Job title/duties
Official Supervisor
Employed from (mm/dd/yyy)
Employed to (mm/dd/yyy)
Reason for leaving
# hours worked per week
Pay rate
May we call this employer?
Yes
No
Final page --->
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