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:
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