Phone: 704-651-3580

Schedule Estimate

Employee Application

    Applicant Information

    Last Name*     First Name*     MI*

    Street Address         Apartment/Unit #

    City     State     ZIP

    Phone         Email*

    Date Available         Desired Salary

    Emergency Contact

    Are you a citizen of the United States? YesNo

    If no, are you authorized to work in the U.S.? YesNo

    Do you have a valid driver's license? YesNo     What State?

    Do you have pending court cases? YesNo    If yes, explain

    Education

    High School      Address

    From   To   Did you graduate? YesNo  Degree

    College      Address

    From   To   Did you graduate? YesNo  Degree

    Other      Address

    From   To   Did you graduate? YesNo  Degree

    References

    Please list three professional references

    Full Name      Relationship
    Company Name      Phone
    Address

    Full Name      Relationship
    Company Name      Phone
    Address

    Full Name      Relationship
    Company Name      Phone
    Address

    Previous Employment

    Company      Phone
    Address      Supervisor
    Job Title      Starting Salary      Ending Salary
    Responsibilities
    From    To    Reason for leaving
    May we contact your previous supervisor for a reference? YesNo

    Company      Phone
    Address      Supervisor
    Job Title      Starting Salary      Ending Salary
    Responsibilities
    From    To    Reason for leaving
    May we contact your previous supervisor for a reference? YesNo

    Company      Phone
    Address      Supervisor
    Job Title      Starting Salary      Ending Salary
    Responsibilities
    From    To    Reason for leaving
    May we contact your previous supervisor for a reference? YesNo

    Years Painting Experience

    New Construction

    Residential Repaint

    Commercial

    Disclaimer and Signature

    I certify that my answers are true and complete to the best of my knowledge.

    If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.

    Type your complete name, which will serve as your electronic signature:
    Today's Date

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