Service Provider Information:

Full Name *

Email *

Phone *

Date of birth *

Gender *

Male
Female
Other
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Marital Status *

Single
Married
Widowed
Divorced
Separated
Common-law Marriage
Registered Partnership
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Address:

Street Address *

City *

State *

Postal code *

Other Details:

What Cleaning Services you Can Offer? *

Authorized to work in U.S.? *

Yes
No
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Valid driving license? *

Yes
No
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Spoken languages: *

English
Spanish
Chinese
Tagalog
Vietnamese
Russian
Arabic
Chinese
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Hourly Rate (Expectation) *

Do you consent to a background check for this application? *

Yes
No
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Other details

Attachments (DL, SSN, resume..etc) *