Application For Employment
Equal Opportunity Employer

A Clean Look
Professional Cleaning For New Construction
Hudson, WI 54016
Ph. 651-248-7669
Admin@acleanlookllc.com
 
Date:

Personal Information
First Name
Last Name
Address
City
State
ZIP Code
Phone Number
Cell Phone
E-Mail Address

Employment Desired
Position
Status Part Time Full Time Either
Date You Can Start
Salary Desired
Are You Currently Employed? Yes No
If So May We Contact Your Current Employer Yes No
  Supervisors Name Phone
Referred By

Education History
  High School
    Name & Location Of School
   
    Years Attended
    Did You Graduate? Yes No
    Subjects Studied
   
     
  College
    Name & Location Of School
   
    Years Attended
    Did You Graduate? Yes No
    Subjects Studied
   
     
  Trade, Business or Correspondence School
    Name & Location Of School
   
    Years Attended
    Did You Graduate? Yes No
    Subjects Studied
   

Former Employers
(list below last four employers, starting with last one first)
  Employer 1
    From Date
    To Date
    Name & Address Of Employer
   
    Salary
    Position
    Supervisor
    Reason For Leaving
   
       
  Employer 2
    From Date
    To Date
    Name & Address Of Employer
   
    Salary
    Position
    Supervisor
    Reason For Leaving
   
       
  Employer 3
    From Date
    To Date
    Name & Address Of Employer
   
    Salary
    Position
    Supervisor
    Reason For Leaving
   

References
(give the names of three persons not related to you,
whom you have known at least one year)
Name Phone Number Relationship Years

Hours Available To Work
  Monday Tuesday Wednesday Thursday Friday Saturday
7:00 a.m.
8:00
9:00
10:00
11:00
12:00 p.m.
1:00
2:00
3:00
4:00
5:00

AREAS ABLE AND WILLING TO WORK
(check all that apply to you)
NORTH METRO
  Arden Hills/Roseville
  Brooklyn Park
  Blaine
SOUTH METRO
  Prior Lake
  Lakeville
  Shakopee
  Bloomington
  Rosemount/Apple Valley/Farmington
   
EAST METRO
  Hugo
  Bayport/Stillwater
  Woodbury
  Cottage Grove
WEST METRO
  Waconia/Victoria
  Carver
  Eden Prairie
  Chaska/Chanhassen
  Minnetrista/Excelsior
  Minnetonka
  Plymouth/Maple Grove

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