Application for Employment

The Bright Shine Cleaning Company L.L.C.

Your Name

First Last

Social Security No:

Home Address: (If different from local address)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone Number:

Mobile Phone Number:

E-mail Address:

Are you a citizen of the U.S or do you have a legal right to work in the U.S?

Any offer of employment is conditional upon you completing Form 1-9 and providing documents establishing your identity and work authorization.

Yes

Are you 18 years of age or Older?

If under 18 years of age, applicant will be required to submit a birth certificate or work certificate as required by State of Federal Law.

Yes

Have you ever been convicted of a felony or misdemeanor.

If "Yes", When and Where?

Yes

If "Yes", please provide details:

Type of employment desired:

Date

How many hours per week would you like to work?

How far do you live?

How were you referred to us?

Provide us 3 references:

Hours Available to Work

From