Employment Application CONTACT INFORMATION Your Name (required) Your Email (required) Cell Phone (required) Other Phone Permanent Address (required) GENERAL INFORMATION Have you ever been convicted of a felony? YesNo If so, please provide details: Position Applying For: Staff PainterForemanOffice Staff Are you legally allowed to work in the US? YesNo Are you a US citizen? YesNo If not, do you have a VISA or Greencard? YesNo How many hours can you work weekly? Hourly rate desired: Are you available on weekends? YesNo When are you available to start? How did you hear about us? DRIVING INFORMATION Do you have a valid drivers license? YesNo If not, what are your means of transportation? Drivers License Number: State: Expiration: What type of license is it? OperatorCommercial (CDL)Chaffeur Do you have a car? YesNo If so, what kind? Make: Model: Year: Have you had any moving violations during the past 3 years? YesNo If so, how many? Have you had any accidents during the past 3 years? YesNo If so, how many? EDUCATION School #1 Type of School: Name of School: Location: Dates Attended: # of Years Comnpleted: Major/Degree Completed: School #2 Type of School: Name of School: Location: Dates Attended: # of Years Comnpleted: Major/Degree Completed: School #3 Type of School: Name of School: Location: Dates Attended: # of Years Completed: Major/Degree Completed: MEDICAL ISSUES In the past three years, have you experienced any medical conditions which may impair or limit your ability to perform the position for which you are applying, including but not limited to back problems, hernia, heart conditions, or epilepsy? YesNo If YES, please explain: WORK EXPERIENCE Please list your employment history, starting from the most recent job held. Most Recent Job Employer Info (Name, Phone Number, Address): Job Title: Duties: Employment Dates: Salary: Immediate Supervisor: Reason for Leaving: May We Contact this Employer for Reference? YesNo Previous Employment Employer Info (Name, Phone Number, Address): Job Title: Duties: Employment Dates: Salary: Immediate Supervisor: Reason for Leaving: May We Contact this Employer for Reference? YesNo Previous Employment Employer Info (Name, Phone Number, Address): Job Title: Duties: Employment Dates: Salary: Immediate Supervisor: Reason for Leaving: May We Contact this Employer for Reference? YesNo Previous Employment Employer Info (Name, Phone Number, Address): Job Title: Duties: Employment Dates: Salary: Immediate Supervisor: Reason for Leaving: May We Contact this Employer for Reference? YesNo PERSONAL REFERENCES First Personal Reference Name: Address: Company: Relationship to You: Phone Number Second Personal Reference Name: Address: Company: Relationship to You: Phone Number Third Personal Reference Name: Address: Company: Relationship to You: Phone Number SKILLS / PERSONAL STATEMENT Why did you decide to apply to Blue Door Painters, Inc.? What skills/experience do you bring us? What is your definition of excellent customer service? What machines or equipment have you operated that relate to the position you are applying for? What other skills do you have that might assist you in the position you are applying for? Do you have your own painting tools? What kind of work have you done? (Check all that apply.) Painting with rollerPainting with brushPaint strippingWallpaperingWallpaper RemovalPower WashingWood ReplacementStaining/SealingDrywall RepairDrywall InstallationPlaster RepairMold MitigationLead MitigationWater Damage RepairGutter CleaningOther (elaborate below) APPLICANT RELEASE False information given or implied on an application form is grounds for immediate dismissal without further notice. I hereby state that all information provided is accurate and may be verified by you. I agree that I may be discharged if the information provided on this application form and related documents is found to be false or have material omissions. If agreed above, Blue Door Painters, Inc. may contact my former employer(s) in connection with my employment with them. All references are herby authorized to release all information which they may have relevant to my employment with them. I hereby release Blue Door Painters, Inc. from any liability that might be claimed because of information provided by such references. Date: Name: