Grace & Grit TN — Employment Application

👤 Personal Information

First Name *

Last Name *

Phone Number *

Email Address

Street Address *

City *

State

ZIP Code

Date of Birth

Social Security # (last 4)

Are you legally authorized to work in the United States?

Yes No

Do you have reliable transportation?

Yes No

Do you have a valid driver's license?

Yes No

💼 Position & Employment Details

Position Applying For *

Employment Type Desired

Desired Pay Rate ($/hr)

Date Available to Start

If referred, who referred you?

📅 Availability

Check all days you are available and indicate your available hours.

Day	Available	From	To
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday

Are you available for occasional early mornings or evenings?

Yes No Sometimes

✨ Experience & Skills

Years of Cleaning / Organizing Experience

Have you worked for a cleaning company before?

Yes No

If yes, please list previous cleaning employers:

Do you have experience with any eco-friendly or non-toxic cleaning products?

Yes No

Describe your cleaning experience and any specialties or strengths:

📋 Work History (Most Recent First)

List up to 3 previous employers.

Employer 1

Employer Name

Job Title

From

To

Phone

May We Contact?

Yes No

Reason for Leaving

Employer 2

Employer Name

Job Title

From

To

Phone

May We Contact?

Yes No

Reason for Leaving

Employer 3

Employer Name

Job Title

From

To

Phone

May We Contact?

Yes No

Reason for Leaving

🌟 References

Please list 2 professional references (not family members).

Reference 1 — Full Name

Relationship

Phone

Email

Reference 2 — Full Name

Relationship

Phone

Email

🔍 Background Information

Have you ever been convicted of a felony?

No Yes

If yes, please explain (date, nature of offense, and disposition). A conviction does not automatically disqualify you from employment.

Note: A felony conviction will not automatically disqualify applicants. Each application is considered individually based on the nature of the offense, how long ago it occurred, and the requirements of the position.

Have you ever been convicted of theft, fraud, or a crime involving dishonesty?

No Yes

If yes, please explain:

Are you willing to consent to a background check?

Yes No

Are you willing to consent to a drug screening?

Yes No

💬 Additional Questions

Why do you want to work for Grace & Grit TN?

How do you handle working in clients' homes? What does professionalism look like to you?

Are you comfortable working independently without direct supervision?

Yes No Sometimes / Prefer some guidance

Are you comfortable around pets?

Yes No Some pets (please specify below)

If no or some, please explain:

Do you have any physical limitations that would prevent you from performing cleaning duties (lifting, bending, kneeling, etc.)?

No limitations Yes, please explain below

Please explain if applicable:

Is there anything else you'd like us to know about you?

✍️ Certification & Signature

I certify that the information provided in this application is true and complete to the best of my knowledge. I understand that any false information or omission may disqualify me from further consideration for employment and may result in dismissal if discovered at a later date. I authorize Grace & Grit TN to verify all information contained in this application, contact my previous employers, and conduct a background check if required. I understand that employment is at-will and may be terminated at any time by either party.

Signature

Date

Printed Full Name

Employment Application

Application Submitted!