Elderly Cleaning Services, LLC
Contact Us: 978.552.9533
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Application for Employment 
Present Address:
Position applying for:
Telephone:
How long?
Applicant Full Name:
Desired salary:
APPLICANTS WILL BE TESTED FOR 
ILLEGAL DRUGS AND CORI
PLEASE COMPLETE ENTIRE PAGE   
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​Weekly hours?
​​Have you had any accidents during the past three years? How many?
When can you start?
NO:
​Do you have insurance on your vehicle and can you provide proof? 
YES:
​Do you have a valid driver's license? 
If YES how Many?
YES:
NO:
State of issue:

Expiration date:
Have you had any moving violations during the past three years? 
YES:
NO:
Copyright © 2013-2017, Elderly Cleaning Services, LLC All Rights Reserved. 
 Location: Massachusetts * Phone: 978.552.9533
 Email address: elderlycleaningservices@gmail.com
Date of birth:
Employment Disclaimer: I certify that I have fully and accurately answered all questions and have given all information requested in this application for employment, and I understand that any wrong or incomplete information on the form may disqualify me for further consideration for employment or, if discovered during interview and or after I am hired, may be grounds for my immediate dismissal. I understand that all such information is subject to verification by Elderly Cleaning Services, LLC, and hereby give my consent to Elderly Cleaning Services, LLC to investigate my background and qualifications using any means, sources, and outside investigators at its disposal. I agree to undergo a CORI check, any type of drug and/or alcohol testing that Elderly Cleaning Services, LLC may require at any time. Finally, I understand this is a preliminary employment application and that submission of this application does not necessarily mean that I will be hired.
X Date:
Signature:
Do you have reliable transportation?
YES:
TRANSPORTATION:
NO:
YES:
NO:
Opportunity!
Are you looking for an exciting and rewarding opportunity? Do you want to serve and give back? Here at Elderly Cleaning Services we take special pride in the services we provide. We are seeking passionate house cleaners with a caring, respectful personality and a desire to clean homes for the Elderly / Senior’s year round. One person can have a tremendous impact within the Elderly community by offering a service they need, want and deserve. We value our customers and enjoy every moment of helping. We value our team, their respectful personality and the services they provide daily. 
Job Description:
* Year round work not seasonal
* Cleaning experience preferred      
* Paid training available based on experiance
* Must be available to work Monday-Friday 
* Must be available 25-30 hours/weekly
* A great personality is always a plus
* Caring and Extremely Honest at all time
* Reliability, Punctuality and Professionalism is imperative 
* Passion for the work you do & respect for the Elders we serve
* Must have valid driver's license 
* Must have a vehicle with proof of insurance 
Uniforms shirts and name tags provided
TODAY'S DATE: