First Name: *

Last Name: *

Street Address: *

City: *

State: *

Zip Code: *

Primary Phone Number: *

Secondary Phone Number:

Other Phone Number:

Best time to call: Select Morning Afternoon Evening

Email Address: *

Are you a citizen of the United States?

Yes

No

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

Yes

No

Have you ever worked for this company?

Yes

No

High School:

Address:

From:

To:

Did You Graduate?

Yes

No

High School Degree:

If asked can you:

HVLP Spray.

Yes

No

Electrostatic Spray.

Yes

No

Airless Spray.

Yes

No

Brush and Roll.

Yes

No

Millwork Finishing.

Yes

No

High work/Industrial.

Yes

No

Preparation (masking, caulking, etc.).

Yes

No

Climb a ladder with a heavy load.

Yes

No

Paint overhead for several hours.

Yes

No

Be exposed to adverse weather conditions.

Yes

No

Work at various heights.

Yes

No

Lift 50 lbs. repeatedly.

Yes

No

Summarize special skills:*

Please list two professional references.

Employer (1):

Address:

City:

State:

Dates (From &ndash To):

Job Title:

Work Duties:

Employer (2):

Address:

City:

State:

Dates (From – To):

Job Title:

Work Duties:

Employer (3):

Address:

City:

State:

Dates (From – To):

Job Title:

Work Duties:

Branch

From

To

Rank at Discharge

Type of Discharge

If other than honorable, explain:

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. I authorize the employer to investigate and verify any of the information I have submitted in applying for employment with the employer. I understand and agree that if hired, my employment will be at-will and may be terminated with or without notice at any time at my option or at the option of the Company. I understand that only a written agreement expressly to the contrary signed by me and the President of the company can vary this employment at will policy. Qualified applicants receive consideration for employment without discrimination because of sex, marital status, race, color, national origin, age or disability.

Verification: *