Name

Address

Phone

Email Address

Last 4 digits of SSN

Are you eighteen (18) years or older? Are you eighteen (18) years or older? Yes No

Are you legally eligible to work in the United States? Are you legally eligible to work in the United States? Yes No

Have you ever worked as a Professional Painter? Have you ever worked as a Professional Painter? Yes No

Have you ever been discharged or asked to resign from a job? Have you ever been discharged or asked to resign from a job? Yes No

If yes, please explain

What rate of pay do you expect if employed?

What type of employment are you seeking? What type of employment are you seeking? Full Time Part Time Summer Seasonal Temporary

On what date would you be available to start work?

Please list all availability. (i.e., Monday-Friday 8AM-5PM)

Are you willing to work Overtime if needed? Are you willing to work Overtime if needed? Yes No

Check the boxes in which you have experience in: Check the boxes in which you have experience in: Residential Exterior Residential Interior Residential Exterior + Interior Commercial Exterior Commercial Interior Commercial Exterior + Interior Brush/Roll Trim Masking Caulking Glazing Operating Boom Lift Spray Siding Pressure Washing Rolling Hand Brush Wallpaper Removal Drywall Repair Cut Ceiling Lines Log/Cedar Staining Recoating

Education and Training Education and Training Highschool Diploma GED College / Vocational School Other

If "Other" please explain

Experience and Work History

Additional information you'd like to include

Please list three (3) references