Employment Application

Last Name

First Name

Middle Name

Street Address

City , State Zip

Home Phone

Cell Phone

Email Address


Position for which you are applying:

Date Available:

List Exact Hours Available (e.g., 4:00 p.m. to 8:00 p.m., etc.):

List any days of the week you are NOT able to work:


Are you at least age 18? YesNo

Are you physically and otherwise able to perform the essential functions of the job for which you are applying, with or without reasonable accommodation?

YesNo

Are you legally eligible for employment in the United States? Proof of identity and employment authorization will be required upon employment: YesNo



Previous Business and Employment Experience

May we contact your current employer? YesNo

May we contact your past employers?YesNo

Please give complete and accurate employment information for the last seven years, starting with the most recent employer first. Accuracy in dates and all other information is essential.

If you have a resume, please send via email.



Current (Or Last) Employer:

Street Address:

City , State Zip

Telephone:

Job Title:

Description of Duties:

Supervisor's Name:

Employment Start Date:

Employment End Date:

Start Wage:

Final Wage:

Reason for Leaving:



Previous Employer:

Street Address:

City , State Zip

Telephone:

Job Title:

Description of Duties:

Supervisor's Name:

Employment Start Date:

Employment End Date:

Start Wage:

Final Wage:

Reason for Leaving:



Previous Employer:

Street Address:

City , State Zip

Telephone:

Job Title:

Description of Duties:

Supervisor's Name:

Employment Start Date:

Employment End Date:

Start Wage:

Final Wage:

Reason for Leaving:



Education

Check the box that indicates the HIGHEST level of education that you have achieved, and enter the requested information about educational institutions.



Completed 12 or Less YearsHigh School Graduate/GEDBusiness/Trade School GraduateAssociate DegreeBachelor DegreePost-graduate DegreeOther

If less than 12, how many years completed?

High School: Name

Location:

Major Course of Study:

Diploma/Degree or Credits Earned:




Business or Technical School: Name

Location:

Major Course of Study:

Diploma/Degree or Credits Earned:




Junior/Community College: Name

Location:

Major Course of Study:

Diploma/Degree or Credits Earned:




College (Undergraduate): Name

Location:

Major Course of Study:

Diploma/Degree or Credits Earned:




Graduate School: Name

Location:

Major Course of Study:

Diploma/Degree or Credits Earned:




Additional/Skills:(i.e. computer skills and / or field skills, drywall, flooring, electrical, wall covering)


References

Give the names of three persons not related to you, who you have known at least one year.



Name:

Address:

Phone:

Years Acquainted:




Name:

Address:

Phone:

Years Acquainted:




Name:

Address:

Phone:

Years Acquainted:



Military Service

Have you served in the U.S. Armed forces? No (skip to next section)Yes If yes, what branch?

Date Entered:

Date Discharged:

Did you receive a dishonorable discharge? YesNo

If yes, explain. Note: A dishonorable discharge is not an absolute bar to employment; other factors will affect a final decision.



I Accept. By selecting the "I Accept" button, you are signing this Agreement electronically. You agree your electronic signature is the legal equivalent of your manual signature on this Agreement.


Information provided is Complete and True; Falsification or Omission of Information Will Result in Termination. I certify that the above information is true and complete. I understand that falsification of this document or omission of information shall result in immediate termination if I am hired.

Employment at Will. I agree that, if hired, I will conform to all rules, regulations and procedures of AAA Painting Contractors, Inc. I further understand and agree that any offer of employment extended to me by AAA Painting Contractors, Inc. is for an indefinite period and may, regardless of the time and manner of payment of my wages and salary, be terminated at any time by AAA Painting Contractors, Inc. or me, with or without cause, and without prior notice or warning. I further understand that this Application for Employment and any policies and procedures communicated or followed by AAA Painting Contractors, Inc. during the term of my employment, are not intended to be and are not a contract of employment, and that any such policies and procedures may be modified, disregarded or eliminated at any time, with or without notice to me, in the sole discretion of AAA Painting Contractors, Inc. Further, I understand that no officer, employee or representative of AAA Painting Contractors, Inc. except its President has any authority to enter into any agreement contrary to the foregoing, and any such agreement must be in writing and signed by the President.

Authorization to Release Educational Records. As an applicant for employment with AAA Painting Contractors, Inc., I authorize the release to AAA Painting Contractors, Inc. of all high school, college and other educational records pertaining to my attendance, course work and other school activities at any educational institution attended by me at any time.

Authorization to Release Employment Records; Waiver of Liability. I authorize the disclosure of any and all information relating to my present and former employment, and I request all current and former employers to supply said information to AAA Painting Contractors, Inc. upon its request. I waive and release my current and former employers from any liability that may arise as a result of providing such information to AAA

Painting Contractors, Inc., and waive and release AAA Painting Contractors, Inc. and its agents from any liability for any action taken due to information provided by any current or former employer.

Expiration of Application. I understand that this Application for Employment shall be considered active for a period of time not to exceed 90 days from this date, and that if I wish to be considered for employment beyond that date, I must submit another employment application.

I understand that any offer of employment will be subject to compliance with the identification and employment eligibility requirements imposed by the U.S. Immigration and Naturalization Service.

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