Employment Application

Seattle

Yakima

"*" indicates required fields

Step 1 of 3

Employment Application

Applications are considered without regard to race, color, religion, sex, national origin, age, marital or veteran status, or the presence of a non-job-related medical condition or handicap.

Job Location*

Personal Information

Date

Start Date

Job Type*

Full Time

Part Time

Temporary

Referral source

Name*

Date of Birth*

Business Name*

Entity

Street Address*

Phone*

City, State, Zip*

SSN

Emergency Contact*

Phone*

Relationship

Have you ever been convicted of or charged with a felony or a misdemeanor?

Yes

Have you, or any person or entity you have been associated with, filed for bankruptcy, been declared bankrupt or insolvent or been the subject of any receivership proceedings within the last seven years?

Yes

If yes, please explain details in full, including date(s), places, amounts involved and disposition

Education

Schools and Colleges Attended

#Years

Year Grad

Degree

Schools and Colleges Attended

#Years

Year Grad

Degree

BUSINESS REFERENCES

Please provide individual and company names, position, addresses and phone numbers for three business references.

Reference #1

Name

Company

Position

Address

City/State/Zip

Phone

Reference #2

Name

Company

Position

Address

City/State/Zip

Phone

Reference #3

Name

Company

Position

Address

City/State/Zip

Phone

PERSONAL REFERENCES

Please provide names, addresses, phone numbers, relationship, and how long known for three personal references.

Reference #1

Name

Relationship

How Long Known

Address

City/State/Zip

Phone

Reference #2

Name

Relationship

How Long Known

Address

City/State/Zip

Phone

Reference #3

Name

Relationship

How Long Known

Address

City/State/Zip

Phone

SPECIAL SKILLS

Describe any special skills or qualifications for this work, including construction experience and tools used:

Declaration*

I CERTIFY that the above answers are true and complete to the best of my knowledge. I authorize PAINTSMITH COMPANY to investigate any statement contained in this application, including accessing public criminal record information for any District, Municipal, or Superior Court in Washington State before and during any employment by said company; and to obtain a credit report on me (and my company if this application is for reselling by a company) as necessary to determine my qualifications. I understand this application is not and is not intended to be any kind of contract or agreement. In the event of employment, I understand that any false or misleading information given in my application, correspondence, or interview may result in immediate termination. I also understand, also, that I am required to abide by all rules, regulations, and policies of PAINTSMITH COMPANY. *

Date*

Phone

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