First Name

Middle Name

Last Name

Present address

Street

City

State

Zip

How long have you lived there?

Home Phone

Cell Phone

Other Phone number

Email Address

Social Security No

Age (must answer if under age 18)

Height

Weight

Do you suffer from a disability? Do you suffer from a disability? yes no

How do you suffer from a disability?

Have you had any major bodily injuries? Have you had any major bodily injuries? yes no

explain major bodily injuries?

Are you: Are you: Single Married Divorced Widowed

Are you capable of lifting heavy weight? (50-100lbs) Are you capable of lifting heavy weight? (50-100lbs) Yes No

Are you freighted by heights? (I.e. ladder work, scaffolding) Are you freighted by heights? (I.e. ladder work, scaffolding) Yes No

Position applied for: Position applied for: Laborer Apprentice Spray Technician Lead Foreman

Wages desired /hr

Employment Desired Employment Desired Full-Time Part Time Seasonal Subcontractor

How many hours can you work weekly?

Are nights OK? Are nights OK? yes no

Are Weekends OK? Are Weekends OK? yes no

What date can you start?

High School

NUMBER OF YEARS COMPLETED

College

MAJOR & DEGREE

Trade School

Have you ever been convicted of a misdemeanor? Have you ever been convicted of a misdemeanor? Yes No

Have you ever been convicted of a felony? Have you ever been convicted of a felony? Yes No

please explain: How you Have been convicted of a misdemeanor?

please explain: How you have been convicted of a felony?

Do you have a valid driver’s license? Do you have a valid driver’s license? Yes No

Driver’s license number

State of issue

Type Of license Type Of license Operator Commercial (CDL)

Expiration date

Do you have current proof of Auto Insurance? Do you have current proof of Auto Insurance? Yes No

What is your means of reliable transportation to work? What is your means of reliable transportation to work? Full Size Pickup Full Size Van Car Small Truck/Minivan

Are you willing to travel? Are you willing to travel? Yes No

Have you had any accidents during the past three years? Have you had any accidents during the past three years? Yes No

Have you had any moving violations during the past three years? Have you had any moving violations during the past three years? Yes No

How many accidents you had during the past three years?

How many voilation you had during the past three year?

Have you ever been cited for driving under the influence of alcohol or any banned substance? Have you ever been cited for driving under the influence of alcohol or any banned substance? Yes No

please explain: How cited for driving under the influence of alcohol

Years of experience

Month of experience

Years of experience

Month of experience

year of experience

Month of experience

Years of experience

Month of experience

Years of experience

Month of experience

Metal Studs liner feet

Years of experience

Month of experience

Drywall Hanging liner sheet

Years of experience

Month of experience

Years of experience

Month of experience

Acoustical Ceilings avg # of S.F of grid installed per day

Years of experience

Month of experience

Years of experience

Month of experience

Please provide a detailed list of all applicable construction skills, training, and/or experience you have:

Please provide a detailed list of some significant jobs you have worked on:

Please list the tools that you own and are willing to use on the job:

Name

Name

Company

Company

Position

Position

Address

Address

Telephone

Telephone

Other Phone No

Other Phone No

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Name of Employer

Name of Employer

Name of last supervisor

Name of last supervisor

City/State:

City/State:

Phone number

Phone number

Employment date from

Employment date from

Employment date to

Employment date to

Pay Start

Pay Start

Pay Final

Pay Final

Salary

Salary

Your last job title

Your last job title

Reason for leaving (be specific)

Reason for leaving (be specific)

List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company.

List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company.

May we contact your present and / or past employers? May we contact your present and / or past employers? Yes No

Did you complete this application yourself? Did you complete this application yourself? Yes No

Who complete this application

check box check box By checking this box and signing below, I confirm that I have truthfully filled out all sections of this form and have not provided false information. I also agree to the terms above.

Signature of applicant SaveClear

Printed Name Typed Applicant's Name

Today,s Date Month / Day / Year