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# 348, Dunmore PA 18512

Employment Questioneer/Application

First name:
Last name:
Street Address:
City:
State:
Zip Code:
Day phone:
Evening phone:
Email address:
What days and times are you available to work?
Do you use text messages?:
   Yes    No
Have you cleaned before?
   Yes    No
Will you work in Scranton area?
   Yes    No
Will you work in Clarks Summit area?
   Yes    No
Will you work in Tunkhannock area?
   Yes    No
Will you work in Olyphant area?
   Yes    No
Will you work in Dunmore area?
   Yes    No
Will you work in Carbondale area?
   Yes    No
Will you work in Pittston area?
   Yes    No
Will you work in Kingston area?
   Yes    No
Will you work in Wilkes-Barre area?
   Yes    No
Will you work in Dallas area?
   Yes    No
Will you work in Honesdale area?
   Yes    No
Will you work in Lake Ariel area?
   Yes    No
Will you work in Stroudsburg?
   Yes    No
Are you willing to take a drug test?
   Yes    No
Are you willing to complete a background check?
   Yes    No
Are you ok with driving your own car from job to job?
   Yes    No
Are you ok with transporting a vacuum, chemicals, and towels in your vehicle?
   Yes    No
Do you have a valid/unrestricted driver's license?
   Yes    No
Do you have valid auto insurance?
   Yes    No
Are you ok driving in bad weather and snow?
   Yes    No
Professional References #1
 


name
company
title
phone#
Professional References #2
 


name
company
title
phone#
Anything else you would like to add?
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