Cleaner Application Form Contact Details Name Mobile Your Email Address Postcode Work Information Are you working? —Please choose an option—YesNo What days/times do you work? Are you looking for other full time work? —Please choose an option—YesNo Are you looking for long term work? —Please choose an option—YesNo Do you iron? —Please choose an option—YesNo What are you doing? Are you registered Self Employed? —Please choose an option—YesNo If not, are you willing to register as self-employed? —Please choose an option—YesNo If so, what? Previous experience? (Years/Months) Hours wanted per week? Willing to travel? VehiclePublicWalk/CycleNo Which areas will you work in? Animals —Please choose an option—CatsDogs Smoker —Please choose an option—YesNo Your History Job history (Past 5 years) Personal Details & Commitments Accomodation —Please choose an option—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? —Please choose an option—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 Δ
