Mid-American Cleaning Contractors

*Position You Are Applying For

*I Prefer (Select either Full Time or Part Time, and also select one a shift preference.)

Full Time

Part Time

1st Shift

2nd Shift

3rd Shift

*Date When You Can Start Work

*Have you been employed by Mid-American Cleaning in the past?

Yes

No

*Prefix

*First Name

Middle Name

*Last Name

*Last Four Digits Of Your SSN

*Street Address

*City

*State

*Zip

Email Address

*Phone Number( 000-000-0000 )

*Do You Have A Valid Drivers License And A Reliable Vehicle You Will Drive To Work?

Yes

No

*Are You Older Than 18 Years Old?

Yes

No

*Are You Legally Permitted To Work In The United States?

Yes

No