Work With Us
As interest in our service increases, we are always on the look out for exceptional people to work with us. If you are experienced and passionate about cleaning and would like to be considered as an associate please complete this questionnaire. Must be responsible and dependable with an eye for detail. Also, since this position is physically demanding you need to be in excellent physical condition.
If your questionnaire meets our criteria we will call to set up a personal interview. At that time we would ask that you to bring along your resume. Thank you for your interest in working with Clean Home Clear Mind.
PERSONAL BACKGROUND (please list in the order arranged below)
Name - Address - City - State - Zip Code - Email Address - Home Phone - Cell Phone
EDUCATIONAL BACKGROUND (please list in the order arranged below)
Name of High School - Location - Highest Grade Completed - Year Graduated
Name of College - Location - Year Graduated
Further Education Name - Location - Degree or Title Earned
WORK EXPERIENCE (please list three in the order arranged below)
1. Name of Employer - Address - Ending Salary - Reason for Leaving
2. Name of Employer - Address - Ending Salary - Reason for Leaving
3. Name of Employer - Address - Ending Salary - Reason for Leaving
PERSONAL REFERENCES (please list three in the order arranged below)
1. Name - Address - Occupation - Phone - Years Known - Relationship
2. Name - Address - Occupation - Phone - Years Known - Relationship
3. Name - Address - Occupation - Phone - Years Known - Relationship
To what extent would the following job characteristics be appealing to you.
(On a scale of 1-10 with 10 being the most appealing)
1. Physical activity and exercise 
2. Flexible work schedule and hours
3. Working in a team environment
4. Helping clients keep their homes clean
5. Getting along well with fellow workers
6. Recognition from management for good work
7. Opportunity to earn bonuses or awards
8. Opportunity to become a team leader/manager
GENERAL QUESTIONNAIRE
(This is a part-time position with the potential to lead to a full time position with advancement)
1. Are you presently working?
2. Do you have an active cell phone?
3. Do you own a computer with Internet access in your home?
4. Do you speak English fluently?
5. Do you speak any other languages fluently?
6. Do you smoke cigarettes?
7. Do you have any allergies to pets, dust, etc.?
8. Do you have any fear of cats or dogs?
9. Do you have any difficulty standing, bending or kneeling while cleaning?
10. Are you able to stand on your feet all day?
11. Are you able to lift up to 30 pounds?
12. Are you available to work on Saturdays?
13. Are you OK with wearing cleaning attire?
14. Are you able to begin work as early as 7:00 AM?
15. Are you familiar with the NYC subway system?
16. What do you like most about house cleaning?
17. What do you dislike most about house cleaning?
18. How do you feel about constructive criticism?
19. How do you feel about texting and talking on a cell phone in the work place?
20. How would you define the term "green cleaning" and what does it mean to you?
21. How do you feel about the phrase "the customer is always right"?
22. How would you describe your work ethic?
23. What are the most overlooked areas people miss when cleaning?
24. If you were asked to re-clean several areas previously cleaned by you, how would you handle this situation?
25. If you knew you were going to be late starting work what would you do?
26. Typically, how many hours of sleep do you get each night?
27. How soon would you be able to start work?
28. Tell us a little about yourself and why you feel you would be ideal to represent Clean Home Clear Mind?
29. Would you like to comment or elaborate on any of your answers to this questionnaire? If so, please do.
30. "I certify that all of the foregoing information is a complete and accurate statement of the facts and understand
that if any misrepresentation, omission or falsification should be discovered, it will constitute grounds for dismissal.
I hereby authorize Clean Home Clear Mind to conduct a background check related to the position I am seeking."
I have read, understand and agree with the above. (complete name and date on line below)
