Name *

First Name

Last Name

Phone

(###)

###

####

Street Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Question #1 *

Do you have professional paid cleaning experience?

Yes, I've worked for a company

Yes, I have my own customers

Yes, I've cleaned for both my own customers and with a company

No, I do not have any professional cleaning experience

Question #2 *

How many years of paid experience do you have?

0 up to 1 year

1-3 years

3-5 years

5+ years

10 years

Question #3 *

How many hours per week are you able to work?

5 -10 hours

10- 20 hours

20- 30 hours

30- 40 hours

Question #5 *

Are you currently working as an independent contractor or subcontractor?

Yes

No

Question #6 *

Do you currently have paying customers for house cleaning?

Yes

No

Question #7 *

How many customers do you currently have?

0

1-5

5-10

10+

Question #9 *

Do you have a Cleaning partner?

Yes

No

Question #10 *

Which of the following do you have? Check all that apply.

Smart Phone

Car

Valid Driver’s License

Bank Account

Cleaning Supplies

Question #11 *

Do you have Business General Liability Insurance?

Yes

No

Question #12 *

Are you legally able to work in the U.S?

Yes

No