Worker Application - Maid to Perfection® of Lake Norman

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217-398-1881

Worker Application

Maid to Perfection is a great place to work! Take the first step - fill out the application below!

Please be sure to answer the Full-Time/Part-Time/Either question and all Yes/No questions, as well as put in an e-mail address where requested. The form will not process otherwise.

Name:

First

Middle

Last

Address:

Street	Apt#

City	County	State	ZIP

HomePhone:

CellPhone:

E-Mail Address:

Social Security Number:

Person To Notify In Case of Emergency:

Name:

Phone Number:

Do you have a relative working at Maid to Perfection®?
(If yes, give name, relationship, department/location)

Yes No

Name, Relationship, Department/Location

Have you ever been employed by Maid to Perfection®?
Yes No
If yes, please complete:

Dates of Employment: From To

Location:

Postition(s) Desired:

Full-Time Part-Time Either

Desired Work Schedule:

	Sunday	Monday	Tuesday	Wednesday	Thursday	Friday	Saturday
Start Time
Stop Time

Have you ever been convicted of a crime? If yes, Explain.
Yes No

Branch of Military (if applicable):
From: To: Rank Acheived:

Are you willing to drive?
Yes No

Make, Model, Year, Color of Car

Education

High School	Name of School:	Full Address:
	Major	Number of Years
	Diploma/Degree
College	Name of School:	Full Address:
	Major	Number of Years
	Diploma/Degree
Other (specify)	Name of School:	Full Address:
	Major	Number of Years
	Diploma/Degree

Employment (List most recent job first):

Company:	Address:	Supervisor's Name:
Job Title/Duties Performed:	Phone Number:	Starting Pay: $	Ending Pay: $
From: Mo. Yr.	To: Mo. Yr.
Reason for Leaving:

Company:	Address:	Supervisor's Name:
Job Title/Duties Performed:	Phone Number:	Starting Pay: $	Ending Pay: $
From: Mo. Yr.	To: Mo. Yr.
Reason for Leaving:

Company:	Address:	Supervisor's Name:
Job Title/Duties Performed:	Phone Number:	Starting Pay: $	Ending Pay: $
From: Mo. Yr.	To: Mo. Yr.
Reason for Leaving:

May we contact your current employer?
Yes No

Personal References (Not Former Employers or Relatives)

Name:	Relationship or Title:	Phone Number:
Name:	Relationship or Title:	Phone Number:

Signature
I certify that the information contained in this application is correct to the best of my knowledge, and I understand that falsification of this information is grounds for dismissal in accordance with Maid to Perfection® policy. I authorize the references and supervisors listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise; and release all parties from all liability for any damage that may result from furnishing same to you. In consideration for my employment, I agree to comform to the rules and regulations of Maid to Perfection® concerning my employment and understand compensation can be terminated at any time, with or without cause, at the option of either the company or myself pursuant to my Wage and Worker Agreement. I understand that no representative of Maid to Perfection®, other than the franchise owner, has any authority to enter into an agreement for employment for any specified period of time, or to make any agreement contrary to the forgoing. Maid to Perfection® does not guarantee employment to anyone for any fixed term, and no promises of duration of employment have been made. By accepting employment, I agree to indemnify and hold the Franchisor harmless against any claims for damages for any reason.

Date:
Signature (type your name):