Name

Email Address

Phone Number

Tell us a little about yourself

What is it that attracts you about this job opportunity?

Do you currently have a full time job? Do you currently have a full time job? yes no

Are you 18 year old or older? Are you 18 year old or older? Yes No

Do you have a reliable source of transportation? (NOTE: we do not require you to use your vehicle on the job, however, a vehicle is required to allow you to meet us at our starting location at the beginning of each shift) Do you have a reliable source of transportation? (NOTE: we do not require you to use your vehicle on the job, however, a vehicle is required to allow you to meet us at our starting location at the beginning of each shift) Yes No

Do you have valid drivers license? Do you have valid drivers license? yes no

Are you legally eligible for employment in the United States? Are you legally eligible for employment in the United States? Yes No

Have you been convicted of a violent or theft related crime? (If Yes, please elaborate) NOTE: you will be required to pass a background check if hired.

How many hours per week are you AVAILABLE to work? How many hours per week are you AVAILABLE to work? 10 - 15 15 - 25 25 - 30 30 +

The cleaning shift we are currently hiring for runs 18 - 25 hours per week. We clean every Wednesday, Thursday, Friday after business hours from 5:30pm - 11:30pm and every Sunday from 5:30AM - 10:30AM.) Are you able to accommodate these hours? The cleaning shift we are currently hiring for runs 18 - 25 hours per week. We clean every Wednesday, Thursday, Friday after business hours from 5:30pm - 11:30pm and every Sunday from 5:30AM - 10:30AM.) Are you able to accommodate these hours? Yes No

What is your minimum desired wage per hour

Do you have professional cleaning experience? Do you have professional cleaning experience? Yes No

Do you work well with others? Do you work well with others? yes no

Do you respond well to constructive criticism? Do you respond well to constructive criticism? yes no

Do you adjust well to change? Do you adjust well to change? yes no

Are you okay with working at a fast pace? Are you okay with working at a fast pace? yes no

Are you able to lift 30 - 50 lbs Are you able to lift 30 - 50 lbs yes no

We can clean up to 4 - 6 facilities a night. Will this be an issue for you physically? We can clean up to 4 - 6 facilities a night. Will this be an issue for you physically? yes no

Are you interested in a long term or temporary role with our company? Are you interested in a long term or temporary role with our company? Long Term Role Temporary Role

Would a role in Leadership interest you? Would a role in Leadership interest you? yes no maybe

As mentioned above, we are a small cleaning company still in our start up phase meaning we operate a little more on the unconventional side in comparison to most established companies. You will be our first hire - will this be an issue for you? As mentioned above, we are a small cleaning company still in our start up phase meaning we operate a little more on the unconventional side in comparison to most established companies. You will be our first hire - will this be an issue for you? yes no

Will a 2 week paid trial run be an issue for you? Will a 2 week paid trial run be an issue for you? yes no

What date are you available to start?

Are you available for a 10 min phone interview? - if so, what time and date works best for you? Are you available for a 10 min phone interview? - if so, what time and date works best for you? Anytime Monday - Friday anytime before noon Monday - Friday anytime After Noon Weekends anytime before noon Weekends anytime after noon