APPLICATION FOR EMPLOYMENT FRESH IMPRESSIONS CLEANING SERVICE PO Box 10604, Oakland, CA 94610-0604 Voice: 925\685-6000 510\832-7670 Fax: 925\682-3408 www.freshimpressions.com PERSONAL INFORMATION: DATE:__________________________ NAME:__________________________________ ADDRESS:_______________________________ CITY:__________________________________ Zip Code:________________________ PHONE #:_______________________________ Soc. Sec. #:______________________ Drivers License #:_____________________ Date of Birth:____________________ Referred by:___________________________ Date you can start:_______________ Employed now?___________________ May we use them for reference?_____ Employer name:___________________________ Phone :#___________________________ WORK HISTORY: Date Name, Address and Reason for Month/Yr. Phone # of Employer Wage Position Leaving _____________________________________________________________________________ From_____________ To___________________________________________________________________________ From_____________ To___________________________________________________________________________ From_____________ To___________________________________________________________________________ DAYS AND TIMES AVAILABLE:___________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ FOREIGN LANGUAGES SPOKEN:_________________________________________________ SPECIAL INTERESTS/HOBBIES:__________________________________________________________ ______________________________________________________________________________ HOUSECLEANING REFERENCES: If you have worked independently list below the names and phone numbers of 3 clients not related to you whom you have worked for. NAME PHONE # MOS/YRS AS CLIENT 1)____________________________________________________________________________ 2)____________________________________________________________________________ 3)____________________________________________________________________________ IN CASE OF EMERGENCY NOTIFY: Name:______________________________________Address____________________________ ___________________________________________Phone______________________________ Relationship:_________________________________ I authorize investigation of all statements contained in this application. I understand that misrepresentation or omission of facts called for is cause for immediate termination of employment. I also understand that employment is for no guaranteed period of time and that Fresh Impressons may for whatever reason terminate my employment at any time. I also understand that in giving notice to Fresh Impressions of termination of employment at least two weeks notice will be expected and complied with. Signature:_____________________________________Date:_________________________ ______________________________________________________________________________ ______________________________________________________________________________ (Do not write below this line)