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We are currently seeking applicants for our Carpet Cleaning Technician position. 
click here for more information about this position.


Employment Application
(short version)

Please complete this short version of our Employment Application.  Once contacted for possible employment, you will complete our regular full version of the Employment Application.  Please click on "Submit" once completed to send this application to us.  Thank-you.

First Name:
Last Name:
Street Address:
Zip Code:
Home Phone:
Cell Phone:
Email Address:
Confirm Email Address:
Do you own a vehicle?:
If yes, year make and model:
Do you have a valid Driver's License?:
If yes, Driver's License Number:
In which State is Driver's License issued?:
Have you ever been fired from any job?:
If yes, please explain:
Have you ever been convicted of any crime?:
If yes, please provide details:
Please tell us your ambitions for the future
and anything else about yourself you think 
we ought to know in considering you for employment :
A routine inquiry may be made which will provide
applicable information concerning character,
general reputation, personal characteristics, and mode
of living. These inquiries may be made from the references
and previous employers listed on this application or with
other third parties. The inquiries may be made by Quick-Kleen
or its agent.

I hereby affirm that the information I have given is true and
complete to the best of my knowledge. I hereby grant permission
to investigate any of the information included in this application and
agree to submit to a medical examination by a physician of the
company's choice when required. I agree that any false statements
or misrepresentations on this application will be sufficient cause for
dismissal from the company's services if I have been employed.:
Any additional Comments you would
like to make in considering you for