Specialized Painting Services

Note: All fields marked with an * asterisk are required.

*Name:

*Address:

*City *State *Zip

*Phone Number:

Email Address:

*Position(s) applied for:

*Referral Source:

*Are you over 18 years of age?
Yes No

If you are under 18 years of age, can you furnish a work permit?
Yes No

If No, please explain:

*Do you have a valid Driver's License?
Yes No State

*Have you submitted an application here before? Yes No

If Yes, give date(s)

*Have you ever been employed here before? Yes No

If Yes, give date(s)

*Are you legally eligible for employment in this country? Yes No

*Are you able to meet the attendance requirements of this position?
Yes No

*Have you ever been bonded? Yes No

*Have you ever plead "guilty" or "no contest" to, or been convicted of a crime?
Yes No

If Yes, please provide date(s) and detail(s).

Answering "Yes" to these questions does not constitute an automatic bar to employment; factors such as date of the offense, seriousness and nature of the violation, rehabilitation and position applied for will be taken into account.

EDUCATIONAL BACKGROUND
List High School, College or Trade/Vocational School:

Education 1

School / City and State:

Years Attended:

Degree/Diploma/Major:

Education 2

School / City and State:

Years Attended:

Degree/Diploma/Major:

Education 3

School / City and State:

Years Attended:

Degree/Diploma/Major:

Skills and qualifications (special training, skills, licenses and/or certificates that may qualify you as able to perform the job-related functions in the position(s) for which you are applying:

Additional comments:

EMPLOYMENT HISTORY
Please explain any gaps in employment in the comments section below:

History 1

*Job Title:

*Date Employed From: *To:

*Employer:

*Employer Address:

*Employer Phone:

Hourly Rate or Wage:
*Starting $ *per
*Ending $ *per

*Summarize the type of work performed and job responsibilities:

*Reason for leaving:

*May we contact for reference? Yes No Later

Comments:

History 2

Job Title:

Date Employed From: To:

Employer:

Employer Address:

Employer Phone:

Hourly Rate or Wage:
Starting $ per
Ending $ per

Summarize the type of work performed and job responsibilities:

Reason for leaving:

May we contact for reference? Yes No Later

Comments:

History 3

Job Title:

Date Employed From: To:

Employer:

Employer Address:

Employer Phone:

Hourly Rate or Wage:
Starting $ per
Ending $ per

Summarize the type of work performed and job responsibilities:

Reason for leaving:

May we contact for reference? Yes No Later

Comments:

PROFESSIONAL REFERENCES
List three (3) professional references who are not realted to you and who you have known for at least one (1) year.

Professional Reference 1

*Name:

*Telephone:

Address:

City State Zip

Number of years known:

Note:

Professional Reference 2

*Name:

*Telephone:

Address:

City State Zip

Number of years known:

Note:

Professional Reference 3

*Name:

*Telephone:

Address:

City State Zip

Number of years known:

Note:

IMPORTANT NOTICE - PLEASE READ

I give the employer the right to contact and obtain information from all references, employers, schools, and to verify the accuracy of the information contained in this application. I hereby release the employer and its representatives from liability for seeking, gathering, and using such information and all other persons, corporations or organizations for furnishing such information.

This application is current for only 60 days. At the conclusion of this time, if I have not heard from the employer and still wish to be considered for employment, it will be necessary to fill out a new application.

I understand that if I am employed, any misrepresentation or material omission made by me on this application may be sufficient cause for immediate termination, whenever it is discovered.

I also understand that if I am hired, I will be required to provide proof of identity and legal authority to work in the United States and that federal immigration laws require me to complete an I-9 Form in this regard.

I understand it is this company's policy not to refuse to hire a qualified individual with a disability because of that person's need for a reasonable accommodation as required by the ADA. The employer does not unlawfully discriminate in employment and no question on this application is used for the purpose of limiting or excusing any applicant from consideration for employment on a basis prohibited by local, state or federal law.

If I am hired, I understand that I am free to resign at any time, with or without cause and without prior notice. The employer reserves the same right to terminate my employment at any time with or without cause and without prior notice, except as may be required by law.

This application does not constitute an agreement or contract for employment for any specified period or definite duration. I understand that no representative of the employer, other than an authorized officer, has the authority to make any assurances to the contrary.

* I have read and fully understand the above and seek employment under these conditions. Yes No

Click the Submit button to send your application.