APPLICANT INFORMATION

First Name

M.I.

Last Name

Date

Street Address

Apartment Number

City

State

Zip

Phone

Date Available

Position Applied For

Desired Salary

Hobbies

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

If So, When?

Have You Ever Been Convicted Of A Felony?

Yes No

If Yes, Explain.

EDUCATION

High School

Name of High School

Address

From

Did You Graduate?

Yes No

Degree

College

Name of College

Address

From

Did You Graduate?

Yes No

Degree

Other Institution

Name of Other Institution

Address

From

Did You Graduate?

Yes No

Degree

REFERENCES

Please List Three Professional References.

Reference 1

Full Name

Relationship

Company

Phone

Address

Reference 2

Full Name

Relationship

Company

Phone

Address

Reference 3

Full Name

Relationship

Company

Phone

Address

PREVIOUS EMPLOYMENT

Previous Employer 1

Company

Phone

Address

Supervisor

Job Title

Starting Salary

Ending Salary

Responsibilities

From

Reason For Leaving

May We Contact Your Previous Supervisor For A Reference?

Yes No

Previous Employer 2

Company

Phone

Address

Supervisor

Job Title

Starting Salary

Ending Salary

Responsibilities

From

Reason For Leaving?

May We Contact Your Previous Supervisor For A Reference?

Yes No

Previous Employer 3

Company

Phone

Address

Supervisor

Job Title

Starting Salary

Ending Salary

Responsibilities

From

Reason For Leaving

May We Contact Your Previous Supervisor For A Reference?

Yes No

MILITARY SERVICE

Branch

From

Rank At Discharge

Type Of Discharge

If Other Than Honorable, Explain

Signature

Date

Employment Application

APPLICANT INFORMATION

EDUCATION

High School

College

Other Institution

REFERENCES

Reference 1

Reference 2

Reference 3

PREVIOUS EMPLOYMENT

Previous Employer 1

Previous Employer 2

Previous Employer 3

MILITARY SERVICE

Why Choose Randy Peters Painting?

Over 37 years experience

Fully Insured

All work Warrantied - 100% Satisfaction Guaranteed

E.P.A. Certified for lead violation

quality paint and materials