Join Our Team - Minit Maids

Date of Application*

Name*

FirstLast

Phone Number including Area Code*

Email

Current Address*

Street AddressAddress Line 2CityStateZIP Code

Date Available*

Desired Wages

Are you legally able to work in the United States?*

Yes
No

Have you ever been convicted of a felony?*

Yes
No

If yes, please explain.

Are you physically able to perform the duties of this position, which include: lifting and carrying 25lbs, bending, twisting, crouching, kneeling, walking and reaching?*

Yes
No

If no, please explain.

Do you have any allergies or fears of cats and/or dogs?*

Yes
No

Employment History

(List current or most recent employment first. We are looking for work history, not only including cleaning experience.)

Company Name (Job 1)

Address

Street AddressAddress Line 2CityStateZIP Code

Phone number with area code

Please list company phone number instead of personal cell phone.

Supervisor Name

FirstLast

Employment Starting Date

Employment End Date

Position Held

Job Duties

Starting Rate of Pay

Ending Rate of Pay

May we contact this employer for a reference?

Yes
No

If you are not currently employed, were you terminated?

Yes
No

If yes, indicate why:

If you were not terminated, why did you leave?

Are you eligible for re-hire?

Yes
No

Company Name (Job 2)

Address

Street AddressAddress Line 2CityStateZIP Code

Phone number with area code

Please list company phone number instead of personal cell phone.

Supervisor Name

FirstLast

Employment Starting Date

Employment End Date

Position Held

Job Duties

Starting Rate of Pay

Ending Rate of Pay

May we contact this employer for a reference?

Yes
No

If you are not currently employed, were you terminated?

Yes
No

If yes, indicate why:

If you were not terminated, why did you leave?

Are you eligible for re-hire?

Yes
No

Company Name (Job 3)

Address

Street AddressAddress Line 2CityStateZIP Code

Phone number with area code

Please list company phone number instead of personal cell phone.

Supervisor Name

FirstLast

Employment Starting Date

Employment End Date

Position Held

Job Duties

Starting Rate of Pay

Ending Rate of Pay

May we contact this employer for a reference?

Yes
No

If you are not currently employed, were you terminated?

Yes
No

If yes, indicate why:

If you were not terminated, why did you leave?

Are you eligible for re-hire?

Yes
No

Please explain any gaps in your work history.

Additional Information

Do you have any restrictions working Monday through Friday from 8:00am – 5:00pm?*

Yes
No

If yes, please explain.

Have you ever worked with Minit Maids?*

Yes
No

If yes, when were you employed?

(Year – Year)

Please explain why you feel like you would be the best candidate for Minit Maids?

Disclaimer and Signature

I certify that my answers are true and complete to the best of my knowledge.

If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.

I understand that if employed by Minit Maids my employment will be for no fixed term and will be terminable, without prior notice, by the company at any time and for any reason Minit Maids deems reasonable.

I understand Minit Maids is a drug free work place and drug testing will happen upon my employment and randomly thereafter.

I agree to authorize the process of a routine police, driving record, and background check.

I understand that all company property such as keys, materials and equipment, uniforms, etc must be returned immediately when requested and that I will not receive my final check until all such property has been returned.

I understand that if I quit without providing a 4 day notice, my pay will be reduced to minimum wage.

I have read and agreed to all the terms listed above.*