House Cleaning and Maid Services
What would you like to be called?
District of Columbia
Are you 16 years old or older?
Home Phone Number
Cell Phone Number
Alternate Phone Number
Maid ServiceMaid Service DriverNew ConstructionNew Construction Driver
Full TimePart Time
How did you find out about House Calls?
List below the last three employers, starting with the last one first.
Name of last employer
Weekly Starting Salary
Weekly Ending Salary
Name/Title of supervisor
Reason for leaving
Give below the names of three persons not related to you. Whom you have known
at least one year.
Relationship To You
Do you have reliable transportation?
Do you have reliable child care?
Currently or in the past, have you been convicted of or completed your sentence
or parole for any crime?
if yes, please explain
Have you ever had any driving violations / tickets in the past?
Do you have a valid driver's license?
If I am hired by House Calls, LLC, I agree that I will be an at-will employee, which
means that either House Calls, LLC or I may end my employment at any time with or
without cause or notice. I agree that no written materials or verbal statements
by House Calls, LLC will constitute an express or implied contract of continued
employment and that this at-will relationship can only be modified in writing by
House Calls' President. I agree that, if hired, I will obey House Calls, LLC rules,
including treating confidentially and information I learn during my employment.
I am not a current user of illegal drugs and I agree that I will never work under
the influence of drugs or alcohol.
There is nothing in my background what would cause a risk to House Call's clients,
employees or property. I authorize House Calls to conduct reference checks, criminal
and driving record checks, and other consumer report investigations. I release all
parties from any liability from providing such information to House Calls in this
regard. I understand that conviction of a crime will not necessarily disqualify
me from employment. I understand that the nature and the relevance of the offense
to the position(s) applied for will determine my elgibility for employment.
I certify that the information I have provided to House Calls is true and complete,
I agree to notify House Calls immediately if I am later charged with any crimes
or (if I am a driver) with a driving offense. I agree that any false information
or omission allows House Calls to refuse to hire me, or to terminate my employement
at any time.
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