Personal Information

Position Applying For

First Name *

Last Name *

Phone *

Email *

Address

Street Address *

City

State

Country

Postal code

SSN / EIN *

Date Available *

Availability *

Full Time

Part Time

Seasonal

Eligibility

ARE YOU LEGALLY ELIGIBLE TO WORK IN THE U.S? *

Yes

No

HAVE YOU EVER BEEN CONVICTED OF A FELONY? *

Yes

No

IF YES, PLEASE EXPLAIN:

ARE YOU CONFIDENT THAT YOU WILL BE ABLE TO PASS A BACKGROUND CHECK? *

Yes

No

ARE YOU PHYSICALLY ABLE TO LIFT/PUSH/PULL AT LEAST 35 POUNDS? *

Yes

No

ARE YOU ABLE TO REACH OVERHEAD AND BELOW THE KNEES, BEND, STRETCH, STAND, SIT, KNEEL OR WALK FOR EXTENDED PERIODS OF TIME ACROSS AN ENTIRE WORK SHIFT. *

Yes

No

DO YOU HAVE A RELIABLE MEANS OF TRANSPORTATION? *

Yes

No

What is it?

DO YOU HAVE A VALID FLORIDA DRIVER’S LICENSE? *

Yes

No

Education

High School

City/State

From / To (Dates)

Graduate

Yes

No

College

CITY / STATE (College)

From/To (College)

Degree

Previous Employers/Business

Employer 1

Employer 1 Email

Employer 1 Phone

Employer 1 Address

Starting Pay

Ending Pay

Job Title

Responsibilities

From / To Dates (employer1)

Reason For Leaving

Employer 2

Email (employer2)

Phone (Employer2)

Address (Employer 2)

Starting Pay (employer 2)

Ending Pay (Employer 2)

Responsibilities (Employer 2)

From/To (Employer2)

Reason For Leaving (Employer 2)

Military Service

Are You a Veteran? *

Yes

No

Branch

Rank at Discharge

From/To (Military)

Type of Discharge

IF NOT HONORABLE, PLEASE EXPLAIN:

Background Check Consent

Neat Geeks is a business where its cleaning agents will be in its customers’ homes or businesses, the company will be conducting financial and criminal background checks through a third-party service provider. By signing and submitting this application, the applicant consents to having a background check as a condition of acceptance to interact with the company’s customers.

ACKNOWLEDGEMENT & CERTIFICATION

I, the Applicant, certify that my answers are true and honest to the best of my knowledge. If this application leads to my eventual retention as an employee, I understand that any false or misleading information in my application or interview may result in my employment relationship being terminated.

Signature *

Clear

Date *