Employment Application
Please fill the application fully. We will contact you in the next few days regarding any open positions. Please email the office if you have any questions. info@countrymaids.com
First *
Your answer
Middle *
Your answer
Last *
Your answer
Address *
Your answer
Phone *
Your answer
Email *
Your answer
Position *
Your answer
Desired Wage *
How much would you like to make?
Your answer
How many hours would you like to work in a week?
Your answer
Hours Available
Our typical workday is from about 8am to 5pm. Sometimes people have kids to care for, classes to take or other jobs they work. What hours would you be available to work each day of the week?
Your answer
Your answer
Your answer
Your answer
Your answer
Criminal History *
Have you ever been convicted of a crime?
Please Explain
If you have been convicted of a crime, please explain the circumstances. If not, please leave this blank.
Your answer
Drivers License
Do you have a valid drivers license?
Do you have a reliable vehicle you can use for work?
Do you have insurance as required by law?
Education *
Briefly describe your education history.
Your answer
Work History *
Briefly describe your work history going back at least 10 years unless you have not worked that long.
Your answer
Current Employer
May we contact your current employer? (Make sure you listed the phone number for your current employer in the last section.)
Please list 3 references we may contact regarding your work history.
Your answer
Other Information
Is there anything else you would like us to know?
Your answer
Application Process *
Did you fill out this application with help from anyone?
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