Employment Application

Your Name (required)

Your Email (required)

Cell Phone(required)

Other Phone

Permanent Address (required)

Have you ever been convicted of a felony?
 Yes No

If so, please provide details:

Position Applying For:
Staff PainterForemanOffice Staff

Are you legally allowed to work in the US?
 Yes No

Are you a US citizen?
 Yes No

If not, do you have a VISA or Greencard?
 Yes No

How many hours can you work weekly?

Hourly rate desired:

Are you available on weekends?
 Yes No

How did you hear about us?

Do you have a valid drivers license?
 Yes No

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?
 Yes No

If so, what kind?

Make:

Model:

Year:

Have you had any moving violations during the past 3 years?
 Yes No

If so, how many?

Have you had any accidents during the past 3 years?
 Yes No

If so, how many?

Type of School:

Name of School:

Dates Attended:

# of Years Comnpleted:

Major/Degree Completed:

Type of School:

Name of School:

Dates Attended:

# of Years Comnpleted:

Major/Degree Completed:

Type of School:

Name of School:

Dates Attended:

# of Years Comnpleted:

Major/Degree Completed:

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?
 Yes No

If YES, please explain:

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?
 Yes No

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?
 Yes No

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?
 Yes No

First Personal Reference

Name:

Address:

Company:

Relationship to You:

Phone Number:

SecondPersonal Reference

Name:

Address:

Company:

Relationship to You:

Phone Number:

Third Personal Reference

Name:

Address:

Company:

Relationship to You:

Phone Number:

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 roller Painting with brush Paint stripping Wallpapering Wallpaper Removal Other (elaborate below) Gutter Cleaning Water Damage Repair Lead Mitigation Mold Mitigation Plaster Repair Wood Replacement Staining/Sealing Drywall Repair Drywall Installation Power Washing

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: