Let’s Work Together! * Let’s Work Together! * Let’s Work Together! * Name * First Name Last Name Phone (###) ### #### Social Security Number * Email * Address Address 1 Address 2 City State/Province Zip/Postal Code Country Are You a U.S. Citizen? * Yes No Have you ever been convicted of a felony? * Yes No If selected for employment are you willing to submit to pre-employment drug screening? * Yes No Highest Education Completed * Highschool Some College College Degree Employer Information: * Employment Information * Add Dates Employed with Pay Rate and Position Employment Information * Add duties Performed and your reason for leaving or wanting to leave. Reference 1 * Add Name, Phone #, and Relationship Reference 2 * Add Name, Phone #, and Relationship Reference 3 * Add Name, Phone #, and Relationship What makes you a good fit for Cinder'Ella In Disguise Cleaning Services? * Acknowledgement and Authorization * I certify that all answers given herein are true and complete to the best of my knowledge I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision. In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. Electronic Signature * Date MM DD YYYY Thank you!