Employment Application

SIMPLY PAINTING, INC.

Name *

First

Last

Phone

Cell

Address

City

Zip

Social Security No.

Driver's License No.

List Your Last Two Employers

Company Name

Phone

Contact Person

Employed From - To

Enter the month/year you started and left this position.

Reason for Leaving

Employer #2

Company Name

Phone

Contact Person

Employed From - To

Enter the month/year you started and left this position.

Reason for Leaving

Work Experience

Work Experience: What types of painting have you done and how many years experience do you have doing it?

Do you have dependable transportation?

Do you have a drivers license?

What types of small hand tools do you own?

What is the minimum hourly wage you would accept?

What was your hourly wage on your last job?

Person to contact in case of an emergency or accident? *

Authorization

Authorization: “ I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for dismissal. I authorize employers listed above to give you any and all information concerning my previous employment.”

Date

Name