Please complete this form and hit the submit button                                        

Date:

Personal Data
Name
Social Security # 
Phone:

Present Address:
Street/Address
City
State   Zip

Prior Address (if less than five years):
Street/Address
City
State   Zip

 

In case of emergency contact:
Name
Street/Address
City
State   Zip
Phone Number

Position Applying for


Date Available
Do you have a drivers license? Yes No

If yes Drivers lic # State:
 

Education

Marin Painting & Sandblasting provides service and employment without regard to otherwise qualified applicants race, color, religion, sex,  sexual preference, handicap or national ancestry. Pay is bases on experience and performance.

Job Qualifications
(use the box below if you feel a need to specify any information that would be helpful)
Painting Sandblasting Parking Lot Striping Asphalt

Employment Experience

Start with your present or last job.  Include any job-related military service assignments and volunteer activities.

1.

Employer 1	Dates Employed From: To:	Work Performed
Address
Telephone Number	Final Salary/Hourly Rate $
Job Title	Supervisor
Reasons for Leaving

2.

Employer 2	Dates Employed From: To:	Work Performed
Address
Telephone Number	Final Salary/Hourly Rate $
Job Title	Supervisor
Reasons for Leaving

3.

Employer 3	Dates Employed From: To:	Work Performed
Address
Telephone Number	Final Salary/Hourly Rate $
Job Title	Supervisor
Reasons for Leaving

4.

Employer 4	Dates Employed From: To:	Work Performed
Address
Telephone Number	Final Salary/Hourly Rate $
Job Title	Supervisor
Reasons for Leaving

Answers to the following questions will not absolutely bar the applicant for employment at Marin Painting & Sandblasting; but will be considered along with other applicant information:

Have you ever been placed on notice of termination or fired from another position?  Yes     No

If "yes" please describe situation:

Have you ever been convicted of negligence or abuse? Yes     No  If "yes" please describe situation:

Please list three persons other than relatives we can call for references:                                                

(Please provide day time phone number)

1.         

Name                                                       Address                                   Phone                                                                                           

2.         

Name                                                       Address                                   Phone 

 

3.         

Name                                                       Address                                   Phone 

 

Applicant's Statement

I certify that answers given herein are true and complete to the best of my knowledge.  I authorize investigation of all statements contained in this application for employment, as may be necessary in arriving at an employment decision. 

This application for employment shall be considered active for a period for time not to exceed 45 days.

Any applicant wishing to be considered for employment beyond this time period should reapply at the time.  This application only covers positions open at the time of application.

In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge.  I understand, also, that I am required to abide by all rules and regulations of the employer.  And that employment can be terminated at any time, with or with out cause, by the employer or employee.

 Date