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EMPLOYEE-Application-1.pdf
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Page 1 PENINGTON PAINTING APPLICATION FOR EMPLOYMENT Qualified applicants receive consideration for employment without discrimination because of sex, marital status, sexual preference, race, color, creed, national origin, age, or the presence of a non-job-related handicap. DATE: _______________________________ SOCIAL SECURITY # _____________________________ NAME: __________________________________________________________________________________ PRESENT ADDRESS: ______________________________________________________________________ Street City State Zip CELL PHONE # _________________________________ HOME # ______________________________ TYPE OF EMPLOYMENT DESIRED: ___________________________________________________________ __________________________________________________________________________________________ Are you a member of a Union? Yes No if yes, what Trade? ______________ Local#_____________ Have you previously worked for us? Yes No If yes, when? _____________________________________ Have you applied for work with us before? Yes No If yes, when? _______________________________ Why did you apply at Penington Painting? _______________________________________________________ Were you referred by a current Penington Painting Employee Yes No? Which Penington Painting employee referred you __________________________________________________ Name of relatives employed at Penington Painting __________________________________________________ EDUCATIONAL BACKGROUND: (Circle last year attended) Major High School: ______________________ 1 2 3 4 Graduated? _______ ____________________ College: __________________________ 1 2 3 4 Graduated? ______ ____________________ Other Training: ______________________________________________________________________________ (Include Apprenticeship) Are you willing to do: High work Swing stage Confined Space Do you have current OSHA 10-30 training Yes No SSTA Training current Yes No Reliable transportation Yes No Other Certifications Yes No Can you work swing shift Yes No Can you work weekends if needed Yes No Can you work 10 hours’ days if needed Yes No Work outside of State Yes No
Page 2 PENINGTON PAINTING APPLICATION FOR EMPLOYMENT Cont. PAINTERS: Professional Background Journeyman Apprentice Bracket # __________ Check areas in which you have had experience: Light Commercial _______ Years Experience Commercial _______ Years Experience Lead Man _______ Years Experience Foreman _______ Years Experience Check areas in which you are skilled: Brush _______ Years Experience Spray, type _____________________________________ Years’ Experience _________ Sandblasting _______ Years Experience Fireproofing _____ Years Experience Hand Taping _______ Years Experience Estimating _____ Years Experience Scaffolding _______ Years Experience Paper Hanging _______ Years Experience Special Coatings _______ Years’ Experience, Types _____________________________________ ___________________________________________________________________________________ Other ______________________________________________________, ________ Years Experience Do you have a current medical condition that we need to be made aware of and accommodate to reduce your Exposure to hazardous chemicals? _____________ if yes, describe_________________________________ _______________________________________________________________________________________ Do you have a current medical condition that will keep you from caring or lifting heavy items such as ladders and 5 gallon buckets? _____________ if yes, describe_________________________________ _______________________________________________________________________________________ Do you have any activities, commitments or responsibilities, which may prevent you from work attendance? Requirements? _________ if yes, describe______________________________________________________
Page 3 PENINGTON PAINTING APPLICATION FOR EMPLOYMENT Cont. Have you ever installed floor coating systems?__________________________________________________ If yes, what material / products have you worked with?____________________________________________ Name project specifics you have installed the floor coating systems on:__________________________________ Have you been convicted of a felony within the last 7 years? _______ If yes, describe in full ______________ ________________________________________________________________________________________ (A Conviction will not necessarily bar you from employment) Have you tested positive, or refused to test, on any pre-employment drug or alcohol test administered by a company with which you applied for employment in the past 2 years? Yes No PREVIOUS EMPLOYERS: (List your most recent employer first) Job Title From / To 1. Name______________________________ _________ _________/____________ Address____________________________ Hourly Rate/Salary $___________ per _________ ____________________________ Reason for Leaving _________________________ Phone Number_______________________ Name of Supervisor _________________________ Job Title From / To 2. Name______________________________ _________ _________/____________ Address____________________________ Hourly Rate/Salary $___________ per _________ ____________________________ Reason for Leaving _________________________ Phone Number_______________________ Name of Supervisor _________________________ Job Title From / To
Page 4 PENINGTON PAINTING APPLICATION FOR EMPLOYMENT Cont. 3. Name______________________________ _________ _________/____________ Address____________________________ Hourly Rate/Salary $___________ per _________ ____________________________ Reason for Leaving _________________________ Phone Number_______________________ Name of Supervisor _________________________ PERSONAL REFERENCES (Not Relatives) Phone Number 1. _____________________________________ ______________________________ 2. _____________________________________ ______________________________ May we contact your present employer? Yes No Did you complete this application yourself? Yes No If not, who did? ________________________________________________________________________ APPLICANT DO NOT WRITE INSIDE THIS BOX. Interviewer’s Comments: Interview Date:________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ Starting Date: ________________ Pay Rate Assigned _________________ Supt. Signature__________________________________________________________________________
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