Applicant Full Name

Full Address

Mobile Phone

Email Address

Date of birth

Are you 18 years or older?
---YesNo

Do you have a valid driver’s license?
---YesNo

Are you currently employed?
---YesNo

Do you have a smartphone?
---YesNo

Have you ever been convicted of a felony or violent crime?
---YesNo

Highest Level of Education
---GEDHigh School DiplomaCollege

How did you hear about us?
---Facebook/InstagramIndeedCraigslistBusiness CardSaw our vansPaint StoreFriend or Family MemberOther

If hired, are you able to submit proof that you are legally eligible for employment in the United States?
---YesNo

Job Information

Job Position Applied For
---PainterClericalSales

Are you able to work 10-hour days & weekends if necessary?
---YesNo

Desired Salary (e.g $/per hour)

Desired Start Date

Do you need special accommodation?
---YesNo

Applicant Skills

Painting

Years of Experience

Carpentry

Years of Experience

Have you worked on extension ladders before?
---YesNo

Applicant Employment History

Employer Name

Supervisor Name

Street Address

City

State

Zip Code

Job Title

Reason for Leaving

Start Date

End Date

Can we contact your supervisor?
---YesNo

Supervisor Phone Number

Applicant Professional Reference

Reference #1

Name

Reference Phone Number

Relationship

Reference #2

Name

Reference Phone Number

Relationship

Reference #3

Name

Reference Phone Number

Relationship

Applicant Resume

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Certification

I certify that the information provided on this application is truthful and accurate. I understand that providing false or misleading information will be the basis for rejection of my application, or if employment commences, immediate termination.

I authorize Old World Painting to contact former employers and educational organizations regarding my employment and education. I authorize my former employers and educational organizations to fully and freely communicate information regarding my previous employment, attendance, and grades. I authorize those persons designated as references to fully and freely communicate information regarding my previous employment and education.

If an employment relationship is created, I understand that unless I am offered a specific written contract of employment signed on behalf of the organization by its CEO, the employment relationship will be "at-will." In other words, the relationship will be entirely voluntary in nature, and either I or my employer will be able to terminate the employment relationship at any time and without cause. With appropriate notice, I will have the full and complete discretion to end the employment relationship when I choose and for reasons of my choice. Similarly, my employer will have the right. Moreover, no agent, representative, or employee of Old World Painting, except in a specific written contract of employment signed on behalf of the organization by its CEO, has the power to alter or vary the voluntary nature of the employment relationship.

Electronic Signature (Your Full Name)

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