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Position for which you are applying*

Salary Desired*

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Name

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Are there any other names to which your employment history, educational background, criminal history or personal references may be verified? If so, please indicate below.

Address*

Street Address Address Line 2 City State ZIP Code

Email*

Phone*

Are you at least 18 years old?

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Can you furnish a work permit?

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If hired, can you present evidence of your identity and authorization to work in the United States?

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Are there any restrictions or time limitations on your eligibility to work in the U.S.?

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Please explain your restrictions

Have you ever been convicted of, received deferred adjudication, or pleaded guilty or no contest to, a felony offense?

Yes
No

Please state the nature of the crime(s), when and where you were convicted, and the disposition of the case.

(Information regarding conviction record will not necessarily bar an applicant from employment, but will be reviewed in light of all the surrounding circumstances, including age at the time of the offense, seriousness and nature of the offense, rehabilitation, relationship of the offense to employment, and federal statutory requirements.)

Employment History

Please select the "CHOOSE FILE" button above to attach a list of all present and past full - and part-time employment starting with your most recent employer, including military service. Please include employer's NAME, ADDRESS, PHONE NUMBER, EMPLOYMENT DATES, NAME OF SUPERVISOR, SALARY and REASON FOR LEAVING.

May we contact your present employer for verification?*

Yes
No

Digital Signature*

I accept and sign this agreement

I certify that all of my statements and information I have given in this application are true, complete, and correct. I also understand that any misrepresentation, falsification, omission, or misleading statement is grounds for rejection of my application, or for my immediate discharge ifl am employed, regardless of the time elapsed before discovery of the statement. I agree to immediately notify Parrent's Painting, Inc., Inc. if! am convicted of any crime involving dishonesty or breach of trust, or a crime of morale turpitude, or if I am convicted of a felony, plead guilty or no contest to a felony, am sentenced to felony probation or receive deferred prosecution or adjudication or a similar disposition for a felony offense for any of the crimes listed above while my application is pending or during my period of employment, if hired. I understand that nothing contained in this application is intended to create an employment contract between me and Parrent's Painting, Inc. In addition, I understand and agree that if I am employed, my employment will be at will, terminable by me or Parrent's Painting, Inc. at any time, with or without cause. No promises or representations contrary to the foregoing are binding on Parrent's Painting, Inc. unless made in writing and signed by me and the President of Parrent's Painting, Inc. I also understand that this application will be kept on file for one (I) year. Ifl have not heard from Parrent's Painting, Inc. and still wish to be considered for employment after that time has passed, I must complete a new application. I hereby give Parrent's Painting, Inc. the right to make a thorough investigation and verification of my past employment, education, and activities and I release all persons and/or entities listed above, in my resume, or other pre-employment materials from any and all liability for damages arising from the supplying such verification and information.

Position: Painter/Tape & Bed

APPLICATION