2025 Clean+Safe Employee Application

1. Full Name (First, Middle & Last) *

2. Address *

3. Contact Information (complete all that apply)

4. May we contact you at work?

YesNo

5. Best time to contact you

6. Earliest date available for work

7. Employment desired (select all that apply)

Part-timeFull-timeDaytimeEvening/Night

8. Position Applying (Cleaner / Manager / Project Team Member)

9. What time are you available to start cleaning each day / evening?

10. What is your desired wage or amount of pay per hour?

11. How were you referred to this position or how did you find out about this position?

12. Have you ever been employed with us before?

YesNo

13. Please list any reason(s) that would prevent you from janitorial labor

14. Please list any acquaintances or relatives employed by Clean+Safe LLC

15. Have you been convicted of a felony?

YesNo

16. Prior work experience

17. Other comments that you feel important in our consideration of your application

18. 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 may result in my release. I authorize Clean+Safe LLC to verify all information provided.

YesNo

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