B&K PAINTING EMPLOYMENT APPLICATION: Personal InformationName* First Middle Last Phone*Email* Social Security Number* Date of Birth:* Month Day Year Current Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Are you currently employed?* Required Wage:* When can you start? MM slash DD slash YYYY Previous Employment:Name of Last Employer* Employer Phone Number*Reason for Leaving?*Dates of Employment?* Can we contact them?YesNoPrevious Employer:*Please list your previous employer, contact phone number, dates of employment, and reason for leaving.EducationHigh School/Years Completed: Technical School/Years Completed: College/Years Completed: Have you received any formal training in the painting industry?*NoYesReferences:Reference #1 Name:* First Last Phone*Reference #2 Name:* First Last Phone*Reference #3 Name:* First Last Phone*General Information:Do you have a valid driver’s license?*Please ChooseYesNoLicense #:* Have you ever been convicted of a felony?*Please ChooseNoYesIf yes, please list convictions that are a matter of public record:* Do you have any physical or emotional limitations that may affect your job performance?*Please ChooseNoYesIf yes, please explain:Do you have any limitations getting to and from work?*NoYesDo you have any objections to working overtime if necessary?*NoYesReleases & Applicant’s Signiture:Consent* I agree to this release of information.In connection with my application for employment and as a condition of continuing employment, I understand that investigative inquires may be made on me including previous employers, schools, consumer credit, criminal convictions, motor vehicle, and other reports. The reports will include information as to my character, work habits, performance, education, compensation, and experience along with reasons for termination of employment from previous employers. Furthermore, I understand that the company may be requesting information from various federal, state, and other agencies which maintain records concerning my past activities relating to my driving, credit, criminal, civil and other experiences as well as claims involving me in the files of insurance companies. I authorize without reservation, any party or agency contacted to furnish the above mentioned information and release all parties involved from liability and responsibility for doing so. I hereby consent to obtain the above information from B&K Painting, and/or any of their agents. This authorization and consent shall be valid in original, fax, or copy form. All applications will be kept on file. All hiring and employment at B&K Painting is at will. I understand this application is not an employment contract, nor can be used to create one. Employment by B&K Painting has no specific term and may be terminated by the employee or B&K Painting with or without notice. I acknowledge that B&K Painting has not made any promises or representations that differ from those contained in this paragraph. I understand, that if hired, I must provide satisfactory documents within 3 days to establish my identity and right to work in the United States, if I am offered a position with B&K Painting, and that failure to provide this evidence will result in the termination of my employment. I release and agree to hold harmless any individual, company, business institution or government agency from all liability with regard to furnishing information to B&K Painting. I agree to release and hold harmless B&K Painting from all liability with respect to the receipt of such information. I certify that the information I have furnished on this application form is true and complete. I understand that if any misrepresentation has been made by me verbally or in writing, any offer of employment made to me may be withdrawn or my subsequent employment with B&K Painting may be terminated.