Cleaner Application Form Contact Details Name Mobile Your Email Address Postcode Work Information Are you working? ---YesNo What days/times do you work? Are you looking for other full time work? ---YesNo Are you looking for long term work? ---YesNo Do you iron? ---YesNo What are you doing? Are you registered Self Employed? ---YesNo If not, are you willing to register as self-employed? ---YesNo If so, what? Previous experience? (Years/Months) Hours wanted per week? Willing to travel? VehiclePublicWalk/CycleNo Which areas will you work in? Animals ---CatsDogs Smoker ---YesNo Your History Job history (Past 5 years) Personal Details & Commitments Accomodation ---OwnRent Time at previous address? (if less than 3 years at current address) Marital Status How many children? Time at address (Years/Months) Time at previous address? (if less than 3 years at previous address) Date of birth Ages School holiday arrangements? Do you provide care for any adults? ---YesNo Relationship? Contingency arrangements Availability: Dates & Times Monday: From Monday: To Tuesday: From Tuesday: To Wednesday: From Wednesday: To Thursday: From Thursday: To Friday: From Friday: To Documents Photo Proof of identity (Passport, driving licence, ID card) Proof of address (Utility bill, bank statement) DBS / PCC CV National Insurance Number Tax UTR