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Employment Application

Name:

Date of Application:

City:

State:

Zip Code:

Phone:

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

Yes

No

Do you have a valid driver's license?

Yes

No

Have you ever been convicted of a Felony?

Yes

No

If Yes, Please Explain:

If Required, Will You Work:

Rotating Shifts

Overtime

Saturdays

Sundays

State Fully Why You Believe You Are Qualified For This Position:

Date You Can Start:

Salary Requirements Per Hour/Month:

Education Completed:

Did Not Graduate High School

Graduated High School

Some College

Graduated College

Masters Degree

Doctorate

Major Course Studied:

Current Employer:

Position:

Salary:

Reason For Leaving:

Start Date:

May We Contact This Employer:

Yes

No

Name of Supervisor:

Contact Number:

Previous Employer:

Position:

Salary:

Reason For Leaving:

Start Date:

End Date:

May We Contact This Employer:

Yes

No

Name of Supervisor:

Contact Number

Potential Employment Availability:

Sunday

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Please Let Us Know The Hours You Are Available Each Day:

Cover Letter:

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Resume:

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Contact Information

Phone: 218-779-4863

Email: northernpaintingandremodeling@gmail.com

Address: Grand Forks, ND 58201

Northern Painting and Remodeling

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