Employment - Claffey's Painting

Your Personal Information

Name*

First Last

Phone*

Address*

Street Address Unit / Suite Number City State Zip Code

Home Phone*

Cell Phone*

Social Security Number or Drivers License*

Email*

Enter Email Confirm Email

If hired, can you provide proof that you are legally able to work in the United States?*

Yes
No

Do you have your own dedicated transportation to get to work, including various job sites in different cities and locations?*

Yes
No

How were you referred to us?*

If security clearance is necessary, can this be achieved?*

Yes
No

If no, please explain:

Employment II

Position Desired*

Salary/Wage Desired:*

What days and hours are you available for work?*

Are you available to work overtime if necessary?*

Yes
No

Are you over 18 years of age?*

Yes
No

If you are under 18 years of age, can you provide a work permit?

Yes
No

When are you available to begin work?*

Are you able to perform the essential functions of the job for which you are applying?*

Yes
No

If No, please explain:

Skills

Do you speak, write, or understand any language other than English?*

Yes
No

If yes, which language and with what proficiency?

Are you able to operate a personal computer?*

Yes
No

Tell us more about your computer skills

What knowledge, special skills and/or individual capabilities do you have which especially prepare you for the position you are applying for?

Hobbies

Current Hobbies

Prior Years

Awards/Organizations

List any awards you have received or organizations you belong to:

Education

Name & City of High School or Trade School:*

Number of Years Completed:*

Did you graduate?

Yes
No

Degree(s) or Diplomas(s):

Major Field(s) of Study:

Name and City of College or University:

Number of Years Completed:

Did you graduate?

Yes
No

Employment History

Your Previous Employers*

please list your previous employers, the dates you worked and the position you held

Employer	Dates Employed	Salary / Wage	Position	Phone

Military Service

Have you served in the Military?*

Yes
No

Have you obtained any special skills or abilities as the result of service in the military?

Yes
No

If yes, please describe:

Personal References

Please list at least two (2) persons NOT related to you who have known you for at least five (5) years.

Reference #1:*

First and last name, address, and phone number.

Reference #2:*

First and last name, address, and phone number.

Acceptance*

I agree to the Terms and Conditions

Applicant's Statement

(Initial in the box directly below each numbered item as read)

1. The information that I have provided on this application is accurate to the best of my knowledge and may be verified by Claffey's Painting or its agents.*

2. I authorized all the schools, persons and organizations named in this application to provide any relevant information in their possession or knowledge to the agents of Claffey's Painting, for use in deciding whether or not to offer me employment and specifically waive any required written notification. I hereby release my former employers and all other persons from any and all claims, demands, or liabilities arising out of or in any way related to such inquiry or disclosure.*

3. I understand that Claffey's Painting is committed to maintaining a drug and alcohol free work place. Accordingly, I may be subject to a pre-employment blood test, urinalysis or other drug/alcohol screening. I further understand that if employed, I may be subject to such a drug and alcohol screening if the General Manager has reasonable suspicion to believe that I am under the influence of a drug or alcohol. My consent to submit to such a test is required as a condition of employment and my refusal to consent shall result in a refusal to hire or, if already employed, termination.*

Applicant Signature:*

4. I understand and agree that any misrepresentation or omission of facts in this application will be justification for refusal or termination of employment, regardless of the time elapsed before discovery.*

5. I understand and agree that the employment for which I am applying for is at-will and such employment may be terminated at any time with or without cause, without prior notice, by either myself or Claffey's Painting. There will be no agreement, express or implied between Claffey's Painting and me for any specific period of employment, nor for continuing or long term employment, unless made in writing, signed by an authorized representative of Claffey's Painting.*

6. I have placed my signature in the space provided below only after I have completed the entire application to the best of my abilities and have carefully read the statements above.*

Applicant Name:*

Date*

Name

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