Employment Application

Personal

Full Name (required)

Address (required)

City, State, Zip (required)

E-Mail (required)

Telephone (required)

Telephone (Other)

Are you at least 18 years of age?
Yes No 

If you are under 18, please state your age.

Have you ever applied for a job with the Company?
Yes No 

Have you ever worked for the Company before?
Yes No 

If Yes, when and for how long?

Position you are applying for (required):
 Painting Roofing Flooring

Other position/s for which you would like to be considered:

Salary expected per year:

What experience qualifies you to work here?

Please indicate the hours you are available each day

Monday:

Tuesday:

Wednesday:

Thursday:

Friday:

Saturday:

Sunday:

Have you served an apprenticeship?
Yes No 

If Yes, how many years and what trade?

If your application is considered favorably, on what date can you begin work?

Education

High School Name and Address

Last grade completed
9 10 11 12 

Did you graduate?
Yes No 

Did you receive your diploma?
Yes No 

College Name and Address

Last grade completed
1 2 3 4 

Did you graduate?
Yes No 

Did you receive your diploma?
Yes No 

Other Education Name and Address

Last grade completed
1 2 3 4 

Did you graduate?
Yes No 

Did you receive your diploma?
Yes No 

Work Experience

Name/Address of Employer

Job Title

Weekly Salary

Reasons for leaving

Dates of employment

Immediate Supervisor Name

Company Phone Number

Name/Address of Employer

Job Title

Weekly Salary

Reasons for leaving

Dates of employment

Immediate Supervisor Name

Company Phone Number

Name/Address of Employer

Job Title

Weekly Salary

Reasons for leaving

Dates of employment

Immediate Supervisor Name

Company Phone Number

Name/Address of Employer

Job Title

Weekly Salary

Reasons for leaving

Dates of employment

Immediate Supervisor Name

Company Phone Number

Personal References

Not former employers or relatives. Include name, address, telephone, and years known.

Reference 1

Reference 2

Reference 3

Reference 4