Mom's Home Services
Employment Application
                                                
Pre-Employment Application

This is a pre-employment application.  It will provide the hiring manager with the primary information that will be used to determine if you are a good fit for our company, and if our company is a good fit for you.  It takes us about 24-48 hours to review this application, check your e-mail and your voice mail regularly, because that is how we will be notifying you that you have been selected for an interview.  Thank you for taking the time to complete this application.  We look forward to meeting you.

DUE TO THE HIGH VOLUME OF RESPONSES, PLEASE DO NOT CALL ABOUT YOUR APPLICATION, IF SELECTED WE WILL CONTACT YOU.  THANK YOU FOR YOUR COOPERATION. 

ALL OF YOUR ENTRIES MUST BE IN CAPITAL LETTERS, IF YOUR ENTRIES ARE NOT IN CAPS, YOUR APPLICATION WILL BE REJECTED.  THANK YOU.

Upon submitting this application, you will be re-directed to the Home Page.

BE SURE TO USE CAPITAL LETTERS (Type CAPS to confirm): *
First Name: *
Last Name: *
Address Street 1: *
City: *
Zip Code: * (5 digits)
State: *
Daytime Phone: *
Evening Phone: *
Email: *
Position Applying For: * *
Do you understand that the work hours for this position are between 8:00 am and 5:00 pm? (Type YES or NO): *
Do you understand that this is a residential house cleaning/maid position? (Type YES or NO): *
Do you have a valid NYS Driver's License? (Type YES or NO): *
Do you have your own vehicle? (Type YES or NO): *
Have you ever been charged with or convicted of a felony or a misdemeanor? (Type YES or NO): *
If you answered YES to the question above, please explain.:
Do you have a High School Diploma or a GED? (Type YES or NO): *
Are you interested in PT or FT? (Please type either PT or FT, not both): *
Are you capable of working on your feet for long periods of time? (Type YES or NO):: *
Are you capable of lifting 25 lbs., regularly. (Type YES or NO): *
Do you have experience working with a House Cleaning Company? (Type YES or NO): *
If you answered YES to the above question, list the company name and how long you were there, and what year(s).:
I understand that a background check is reqired (type YES or NO): *
How many residences have you LIVED AT in the past 2 years?: *
Are you employed at this time?(Type YES or NO): *
If you answered yes to the above question, when did you start working for your current employer?:
Do you plan to continue working for your current employer?(Type YES or NO):
If you do not plan to stay with your current employer, tell us why you want to leave.:
 

Take a moment and tell us when you are available to work on these days of the week.  Keep in mind that all of our cleaning occurs between the hours of 8:00 am - 5:00 pm.  If you are available all day, then just enter ALL DAY. 

When are you available to start?: *
Monday Availability: *
Tuesday Availability: *
Wednesday Availability: *
Thursday Availability: *
Friday Availability: *

EMPLOYMENT DATA:

Please list all employers for the past 2 years (24 months), If you were not employed for any portion of the last 24 months, then you must list what you were doing during that period of time.  Please do not leave any time gaps, this will cause your application to be rejected.  List out the past 2 years starting with the most recent and working your way to the less recent.    
Employer 1: *
Employer1 Phone Number
Period Employed (MM/YY - MM/YY): *
Ending Salary: *
Reason for leaving employer 1:
Employer 2 Name:
Employer 2 Phone Number:
Employer 2 Period Employed (MM/YY - MM/YY):
Ending Salary 2: *
Reason for leaving Employer 2:
Employer 3 Name:
Employer 3 Phone Number:
Employer 3 Period Employed (MM/YY - MM/YY):
Ending Salary 3: *
Reason for leaving Employer 3:
Employer 4 Name:
Employer 4 Phone Number:
Employer 4 Period Employed (MM/YY - MM/YY):
Ending Salary 4: *
Reason for leaving Employer 4:
  I have had more than 4 jobs in the past two years.
Tell us about why you would be a good for our customers.: *
I understand that if I call any numbers on this website, will cause my application to be rejected.  (Type your FIRST and LAST NAME) *
  By checking this box I am affirming that all of the information in this application is true. Furthermore, I understand that by making false statements in this application, I will not be eligible for employment, and in the event I am hired, and information is found to be false, that will be grounds for immediate termination.

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