Name:

First Middle Last  

Social Security number     DL# State     Birth date  mm/dd/yyyy

Address:

Street City State Zip code

Phone #:

Home Cell Best time to call

__________________________________________________________________________________________________________________________

Previous employment. List current or last employer first.

Company name #1 Name of supervisor

Street City State Zip code

Dates of employment  to Reason for leaving

Salary or dollars per hour 

Position held   Contact ph#

May I contact this employer?   yes  no  If no, why not?

Company name #2 Name of supervisor

Street City State Zip code

Dates of employment to Reason for leaving

Salary or dollars per hour 

Position held Contact ph#

May I contact this employer?   yes  no  If no, why not?

Company name #3 Name of supervisor

Street City State Zip code

Dates of employment to Reason for leaving

Salary or dollars per hour 

Position held Contact ph#

May I contact this employer?   yes  no  If no, why not?

__________________________________________________________________________________________________________________________

Military

Are you a veteran?    yesno       What branch?

__________________________________________________________________________________________________________________________

Other

Please describe any other experience or skills that you have relating to residential home construction or remodeling. 

When will you be available to start?  Immediately within 1 week within 2 weeks need more time

This job requires you to drive yourself to various locations, sometimes more than one in a single day. Do you own a vehicle? yes no

Do you have the ability to lift 60 pounds on a regular basis? yes no

What salary or dollars per hour are you expecting?