Name
*
First Name
Last Name
Phone
*
Country
(###)
###
####
Alternative Phone
Country
(###)
###
####
Email
*
How were you referred to us?
Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Date Available to Start
*
MM
DD
YYYY
If you are under 18 years of age can you provide a work permit?
--Please Select --
Yes
No
If no, please explain
Have you ever worked for Paint Innovators, Inc.?
*
--Please Select --
Yes
No
If yes, when?
MM
DD
YYYY
Are you legally allowed to work in the United States?
*
-- Please Select --
Yes
No
Type of employment desired
*
-- Select Option --
Full-time
Part-time
Temporary
Have you ever pleaded guilty, no contest or been convicted of a crime?
*
-- Please Select --
Yes
No
Company Name
*
Company Address
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Starting Job Title at Company
*
Responsibilities at Company
*
Number of Years Worked at Company
Ending Job Title at Company
Reason for leaving
May we contact this employer as a reference?
*
-- Please Select --
Yes
No
Company Name
*
Company Address
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Starting Job Title at Company
*
Responsibilities at Company
*
Number of Years Worked at Company
Ending Job Title at Company
*
Reason for leaving
May we contact this employer as a reference?
*
--Please Select --
Yes
No
Summarize Your Special Skills or Qualifications
*
Reference's Name
First Name
Last Name
Reference's Phone Number
Country
(###)
###
####
Reference's Email
Relation to Reference
I certify that my answers are true and complete to the best of my knowledge. I authorize you to make such investigations and inquiries of my personal, employment, educational, financial, and other related matters as may be necessary for an employment decision. I hereby release employer, schools or individuals from all liability when responding to inquiries in connection with my application. In the event I am employed, I understand that false or misleading information given in my application or interview(s) may result in discharge.
*
I Agree