JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
HomeBlis.com - Service Provider Application
Please provide information about your Business and the services you offer in the next few steps.
Sign in to Google
to save your progress.
Learn more
* Required
Do you and your team members meet the below requirements ?
*
Position Requirements: Professional Experience 1.
Must have previous experience with residential/commercial for the service you are applying for 2. Great attitude is a must 3.
Must be very customer oriented 4.
Must have great attention to detail 5.
Willing to go above and beyond Hiring Requirements 6.
Must be authorized to work in the United States 7.
A criminal background check will be performed 8.
Must be fluent in English 9.
Must have mobile phone with text 10.
Must have internet access on a daily basis 11.
Must have vehicle in good condition
Yes
No
Required
Business Information
Official Name of Business/ Individual
*
Your answer
Type of Business Operation
*
Your Business structure
Choose
Sole Proprietorship
Limited Liability Company
Partnership
C-Coprporation
S-Corporation
Individual /DBA
Business Address
*
Your answer
Business Phone Number
*
Your answer
Number of Years in Business
*
Your answer
Number of permanent employees
Your answer
Number of temporary employees
Your answer
Business EIN or Personal Tax ID (SSN)
Tax ID
Your answer
Business Principals' information
Owner / Main Contact Name
*
Your answer
Owner / Main Contact Phone Number
*
Your answer
Owner / Main Contact Cell Phone Number
Your answer
Owner / Main Contact - Email Address
Your answer
Service Information
Please select the service(s) that you would like to provide through HomeBlis.
*
You must have the required licenses and permits for the trades that are regulated by the city or state you serve.
Choose
Residential Cleaning
Commercial Cleaning
Lawn Mowing
Lawn Fertilization & weed control
Lawn Mowing, Fertilization & weed control
Carpet Cleaning
Window Cleaning
Heating and Air
Pest Control
Duct and Vent Cleaning
Irrigation
Which locations do you serve?
Please specify City, State or County, State or Zip codes separated by commas
Your answer
Licensed and accreditations
Pleas provide the names and details of any licenses and accreditations you have .
e.g.
- TN state licensed for Weed and Fertilization spraying
- Rated A+ on BBB etc
License / Accreditation 1
Your answer
License / Accreditation 2
Your answer
Insurance / Bond Information
Please provide insurance type with coverage amount
Insurance 1 : Type and Coverage amount
Your answer
Insurance 2 : Type and Coverage amount
Your answer
Work References & Background check
Please provide names and contact information for reference check
Reference 1: Name and Contact Information
*
Please provide Email and/or phone
Your answer
Reference 2: Name and Contact Information
Please provide Email and/or phone
Your answer
Other
If all requirements are met, will you provide us with Authorization for Background check?
*
We will send you a direct link to provide personal information to our partner to conduct a background check.
Yes
No
Required
HAVE YOU EVER BEEN CONVICTED OF A CRIME?
*
Yes
No
Required
If yes, explain number of conviction(s), nature of offense(s) leading to conviction(s), how recently such offense(s) was/were committed, sentence(s) imposed, and type(s) of rehabilitation
Your answer
Submit
Page 1 of 1
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
