Job Application Cleaner Derby – Join EcoTouch Cleaners

Looking to work with one of Derby’s most trusted cleaning services? Fill out the form below to apply. We’re always looking for reliable, detail-oriented individuals to join our growing team.

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Name *

First

Last

Gender *

• Male
• Female

Address *

Email *

Phone Number *

Date of Birth *

Bank Account Name *

Account Number *

Sort Code *

Bank Name *

Emergency Contact Name *

Emergency Contact Phone No *

Emergency Contact Relationship *

National Insurance Number *

Nationality *

Right to Work in the UK *

• Yes
• No

If yes, Visa/Permit Type *

Available Start Date *

Preferred Working Hours *

• Flexible hours
• Weekends only
• Evenings only

Transport Method *

• Own car
• Public transport
• Walking/Cycling

rejection Contact Name

Willing to travel within (miles/km) *

Previous Cleaning Experience (check all that apply) *

• Professional cleaning company
• Private households
• Commercial/office cleaning
• Hospital/healthcare cleaning
• School/educational facilities
• No previous experience

Previous Employers: Company Name *

Previous Employers: Position *

Previous Employers: Duration *

Previous Employers: Reason for Leaving *

Relevant Certifications *

• First Aid Certificate
• Health & Safety Training
• COSHH Training

Relevant Certifications: Other *

Physical Requirements (check all that apply) *

• Able to lift up to 20kg
• Comfortable working at heights
• Able to stand for long periods
• Able to bend/kneel/reach regularly

Cleaning Skills (check all that apply) *

• Floor cleaning
• Window cleaning
• Bathroom/toilet cleaning
• Kitchen deep cleaning
• Dusting and polishing
• Waste management
• Use of industrial equipment
• Chemical handling/mixing

Equipment Experience (check all that apply) *

• Vacuum cleaners
• Floor polishers
• Pressure washers
• Steam cleaners

Reference 1: Name *

Reference 1: Relationship *

Reference 1: Company *

Reference 1: Phone *

Reference 1: Email *

Reference 2: Name *

Reference 2: Relationship *

Reference 2: Company *

Reference 2: Phone *

Reference 2: Email *

Willing to undergo a DBS check? *

• Yes
• No

Any health conditions affecting your ability to clean? *

• Yes
• No

 If yes, provide details *

Language Proficiency

• English
• Fluent
• Good
• Basic

Other languages *

Are you able to lift/move light equipment (eg. Vaccum, mop, bucket) If no, please specify *

I give consent for my data to be stored and processed for employment and payroll purposes *

• Check the Box

Declaration: I confirm that all information provided is true and complete. I understand that false information may result in rejection or dismissal. *

• True
• False

Signature: print name in bold *

Date *

Submit