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Employment Application
Please note - if you do not meet the minimum qualifications for the job applied for your application will be rejected
Personal Information
E-Mail:*
First Name:*
Last Name:*
Address Line 1:*
Address Line 2:
City:*
State:*
Zip Code:*
Home Phone:*
Business Phone:
Cell Phone:
Work Preference
Date Available:*
Date Available:*
Available to work*
Monday - Friday 8:30 am - 4:30 pm
Tuesday - Saturday 8:30 am - 4:30 pm
Only a couple of days each week 8:30 am - To be discussed
Only a couple of days each week starting later
Postion Applied For:*
Minimum Acceptable Weekly Salary:*
Employment Requested:*
Full Time
Part Time
Temporary
Education
High School Name/Location:*
Diploma Received:*
Diploma
Equivalency
None
College Name/Location:
Degree Earned:
Attended from:
Attended To:
Major/Minor:
College Name/Location:
Degree Earned:
Attended from:
Attended To:
Major/Minor:
Employment History
Name Of Employer:*
Address Line 1:*
Address Line 2:
City:*
State:*
Zip Code:*
Employed From:*
Employed To:*
Employer Phone:*
Job Title:*
Supervisor Name:*
Reason For Leaving:*
Name Of Employer:
Address Line 1:
Address Line 1:
Address Line 2:
Address Line 2:
City:
State:
Zip Code:
Employed From:
Employed To:
Employer Phone:
Job Title:
Supervisor Name:
Reason For Leaving:
Name Of Employer:*
Address Line 1:
Address Line 1:
Address Line 2
City:
State:
Zip Code:
Employed From:
Employed To:
Employer Phone:
Job Title:
Supervisor Name:
Reason For Leaving:
Related Knowledge/Skills:*
Personal References
Please list three (NON BUSINESS RELATED) persons whom have known you for at least 2 years.
Reference Name:*
Address:*
Occupation:*
Phone:*
Reference Name:*
Address:*
Occupation:*
Phone:*
Reference Name:*
Address:*
Occupation:*
Phone:*
Background
HAVE YOU EVER PLED GUILTY TO OR BEEN CONVICTED OF A FELONY OR A FIRST DEGREE MISDEMEANOR?
*
Yes
No
DO YOU HAVE A VALID DRIVERS LICENSE, A RELIABLE CAR TO GET TO JOBS THROUGHOUT THE DAY AND FULL INSURANCE COVERAGE?
*
Yes
No
ARE YOU AVAILABLE MONDAY THROUGH FRIDAY STARTING AT 8:30 AM?
*
Yes
No
ARE YOU AVAILABLE ONLY A COUPLE OF DAYS(LESS THAN 5 DAYS) A WEEK STARTING AT 8:30 AM?
*
Yes
No
CAN YOU PASS A DRUG TEST AND CRIMINAL BACKGROUND CHECK?
*
Yes
No
ARE YOU A U.S. CITIZEN OR ARE YOU LEGALLY AUTHORIZED TO WORK IN THE U.S.?
*
Yes
No
UPLOAD YOUR RESUME
 
READ THE STATEMENT AND TYPE YOUR NAME IN THE SPACE PROVIDED IF YOU AGREE AND ACKNOWLEDGE THE FOLLOWING TERMS: I certify that answers given herein are true and complete to the best of my knowledge and I authorize investigation of all statements contained in this application for employment as it may be necessary in arriving at an employment decision. I hereby understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with this organization is of an `at will` nature, which means that the Employee may resign at any time and the Employer may discharge Employee at any time with or without cause. It is further understood that this `at will` employment relationship may not be changed by any written document or by conduct unless such change is specifically acknowledged, in writing, by the owner. In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand also, that I am required to abide by all rules and regulations of the Employer.

Please note - This electronic application serves only as a preliminary application and is used to pre-screen applicants prior to an invitation to an in person interview. If chosen applicants will be required to fill out a more detailed application at the time of the in person interview.
By electronically signing this application I authorize Maid to Order`s representives to check my references and employment history
ELECTRONIC SIGNATURE*
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