Please fill out the application below completely to be considered for the Shore Thing Cleaning team. This form is hosted on a secure server, and all data is transmitted securely with SSL 128-bit encryption for your protection. PERSONAL INFORMATION * SSN: * LAST Name:   * First:   * Middle: Address: City:   State:   Zip: * Phone:   Alt. Phone: E-mail: Referred By: Do you have your own   reliable transporation? Yes     No If applicable, do you have   reliable child care available? Yes     No FORMER EMPLOYERS   List below your last four employers, starting with the most recent one first. Start Date (Month & Year):   End Date (Month & Year): Employer Name: Employer Address: Salary:   Position: Reason For Leaving: Start Date (Month & Year):   End Date (Month & Year): Employer Name: Employer Address: Salary:   Position: Reason For Leaving: Start Date (Month & Year):   End Date (Month & Year): Employer Name: Employer Address: Salary:   Position: Reason For Leaving: Start Date (Month & Year):   End Date (Month & Year): Employer Name: Employer Address: Salary:   Position: Reason For Leaving: REFERENCES   Give below the names of three persons not related to you, whom you have known for at least one year. Name: Address: Phone:       # of Years Known: Business: Name: Address: Phone:       # of Years Known: Business: Name: Address: Phone:       # of Years Known: Business: Comments: