Employment Application

Please complete the online Employment Application below.

				Date
APPLICANT INFORMATION
Last Name		First Name		Date of Birth (*Optional)
A value is required.		A value is required.		A value is required.
Address				Apartment #
A value is required.
City		State		Zip Code
A value is required.		A value is required.		A value is required.
Home Phone		Cell Phone		Email
A value is required.				Invalid format. A value is required.
Are you a citizen of the United States? Yes No Please make a selection.			If not, are you authorized to work in the US? Yes No
Social Security Number (*Optional) Invalid format.
REFERENCES * NOTE: REFERENCES MUST BE VERIFIABLE *
1. Full Name or Company			Phone
A value is required.			A value is required. A value is required.
2. Full Name or Company			Phone
A value is required.			A value is required.
3. Full Name or Company			Phone
A value is required.			A value is required.
PREVIOUS EMPLOYMENT
1. Company			Phone

City/State			Dates Employed

Responsibilities

Reason for Leaving

2. Company			Phone

City/State			Dates Employed

Responsibilities

Reason for Leaving

3. Company			Phone

City/State			Dates Employed

Responsibilities

Reason for Leaving

MILITARY SERVICE
Branch		From		To

Rank at Discharge			Type of Discharge

Please explain if discharge was other than honorable.

EMPLOYMENT QUESTIONAIRE
1. How many years of CONSISTENT painting experience do you have?
A value is required.
2. Do you have painter's whites?				Yes No Please make a selection.
3. Do you have basic hand tools?				Yes No Please make a selection.
4. Do you have experience with 18" rollers?				Yes No Please make a selection.
5. Do you have experience with sprayers?				Yes No Please make a selection.
6. Would you be willing to submit to drug and/or alchohol testing?				Yes No Please make a selection.
7. Do you have comercial painting experience?				Yes No Please make a selection.
8. Do you have lift experience?				Yes No Please make a selection.
9. Are you Spanish/English bilingual?				Yes No Please make a selection.
10. Do you have reliable transportation? Meaning, can we depend on you to report to work EVERY DAY?				Yes No Please make a selection.
11. Have you ever been convicted of a crime?				Yes No Please make a selection.
	If you have been convicted, please supply the following details:
	Felony or Misdemeanor?		None Misdemeanor Felony
	Person or Property?		None Property Person
	Details:

12. Have you ever been injured on a job site?
	Yes No Please make a selection.	If yes to having been injured, please explain:


13. If you are a sub-contractor, do you have verifiable workers compensation and general liability coverage?				Yes No
14. If you are a sub-contractor, how many are in your crew?
15. If you are a sub-contractor, do you understand that you will be held responsible for the actions and attitudes of your crew?				Yes No
COMPANY POLICIES
Ed Staib Painting wants to encourage a safe and pleasant work atmosphere. This can only happen when everyone cooperates and commits to appropriate standards of behavior. WORK SITE SAFETY The following is a list of behaviors that the company considers unacceptable. Any employee found engaging in these behaviors will be subject to disciplinary actions including reprimand, warning, layoff, or dismissal: Failure to be at the work place, ready to work, at the regular starting time. Failure to notify supervisor or owner immediately if you will not be at/or will be late to, the job site. Willfully damaging, destroying, or stealing property belonging to fellow employees or the company. Refusing or failing to carry out any instructions of a supervisor. Coming to work under the influence of alcohol or any drug, or bringing alcoholic beverages or drugs onto company property. DRUG USE IS NOT TOLDERATED WITH THIS COMPANY. Intentionally giving any false or misleading information to obtain employment or a leave of absence. No personal cell phone use during business hours. Emergencies only. You should only use your cell phone during your break time. Failing to wear clothing conforming to standards set by the company. Not taking proper care of, neglecting, or abusing company equipment and tools. Using company equipment in an unauthorized manner. Must own Basic Painting tools. IMPROPER USE OF RESPIRATOR EQUIPMENT USED WHEN SPRAYING OR NON-USE OF RESPIRATOR DURING SPRAYING OF ANY SOLVENT BASED APPLICATIONS. BY SIGNING THIS DOCUMENT YOU RELEASE ALL RESPONSIBILITIES PRESENT AND FUTURE OF ANY HEALTH ISSUES FROM ED STAIB ENTERPRISES INC., LOCATED AT 11762 BARB CT., LARGO, FL. LUNCH BREAKS Employee is entitled to a 30 minute to 1 hour lunch break that will be taken off the clock. Employee is entitled to two 15 minute breaks during an 8 hour work day. Employee may smoke OFF THE JOBSITE only during the lunch break or the two 15 minute breaks during the work day. Said Employee MUST properly dispose of personal trash including lunch trash, cigarette butts and matches. PAYROLL Must give a 2 weeks notice prior to quiting. Must perform to hourly rate and complete a reasonable amount of work in an 8 hour day. No Employment, unless ALL REQUIRED, SIGNED DOCUMENTATION is on file. This includes: employment application, I-9 (Employment Eligibility Verification), W-4, AND copies of both your driver's license and social security card. Our payroll system is setup one week behind, which means you will receive your first check TWO WEEKS after your start date ( No Exceptions ).
DISCLAIMER & SIGNATURE
I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release. I also understand, and agree to follow the above company polices as stated. By submitting this application online, you are giving us your digital signature.

SIGNATURE (please type your full legal name)				Date
A value is required.				A value is required.
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