Application for Employment Fill out as accurately as possible. Fields marked with an * are required! Date* MM slash DD slash YYYY We are committed to a policy of Equal Employment Opportunity and will not discriminate on any legally protected basis, including, but not limited to, race, age, color, religion, sex, national origin, citizenship, ancestry, physical or mental disability, veteran status, or any other legally protected basis.Personal Information Name* First Middle Last Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Phone*Email* Do you have a valid driver's license?* Yes No Do you have a valid vehicle registration?* Yes No Do you have auto insurance on yourself and vehicle?* Yes No Are you legally authorized to work in the U.S?* Yes No Are you comfortable reading, speaking, understanding and writing English?* Yes No Are you able to lift 25 pounds or more?* Yes No Would you have difficulty standing, bending, or kneeling in connection with performing necessary cleaning duties?* Yes No Are you allergic to Household Chemicals?* Yes No Do you have any allergies to pets* Yes No Are you afraid of cats and/or dogs* Yes No AvailabilityOur business hours are 8am to 5pm Monday through Saturday, what times can you work?*If hired, what date can you start?* MM slash DD slash YYYY Are you presently employed?* Yes No Which of the following categories of jobs have you had? House Cleaning Fast Food Homemaker Hotel/Motel Janitorial Manufacturing Restaurant Sales Service Other (explain below) Please Submit your resume.Max. file size: 32 MB.Please upload your resume in PDF format.Additional InfoCan you go without smoking up to 6 hours?*Is there anything we should know about?We supply all cleaning products. PLEASE READ CAREFULLY AUTHORIZATION AND CONSENT FOR RELEASE OF INFORMATION I, the undersigned, do hereby certify that the information provided by me for the purpose of employment is true and complete to the best of my knowledge. I understand that if I am employed, any false statements will be considered as cause for possible dismissal. I authorize T.L.C. Home Services LLC., and any security agency service working for them, to disclose orally and in writing the results of this verification process and/or interview to the designated authorized representative of this company. I have read and understand this release and consent, and authorize the background verification. I authorize persons, schools, current and former employers, personal references and other organizations and Agencies to provide T.L.C. Home Services LLC., with all information that may be requested, and to conduct a verification, as deemed necessary by this Company to fulfill the job requirements, with regards to my motor vehicle records, credit history as allowed by EEOC and ECOA, and to receive any criminal history record information pertaining to me which may be in the files of any Federal, State or Local criminal justice agency in Massachusetts or any other States. I hereby release all the persons and Agencies providing such information from any and all claims and damages connected with their release of any requested information. I agree that any copy of this document is as valid as the original. All results will be proprietary and will be kept CONFIDENTIAL and disclosed orally and in writing only to the designated authorized representatives of this Company and its Clients. I do hereby agree to forever release, discharge and indemnify T.L.C. Home Services LLC., and their associates to the full extent permitted by law from any claims, damages, losses, liabilities, costs and expenses, or any other charge or complaint filed with any agency arising from the retrieving and reporting of information.*YesNoDo you agree to this statement?Your Full Name*Date* MM slash DD slash YYYY I understand that checking this box constitutes a legal signature confirming that I acknowledge and agree to the above Terms of Acceptance. CommentsThis field is for validation purposes and should be left unchanged. Δ
