Contractor Application .pdf

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Original filename: Contractor Application.pdf
Author: BlueLeaf Flooring

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Contractor Application
Applicant Information
Full Name:

Date:
Last

First

M.I.

Address:
Street Address

Apartment/Unit #

City

Phone:

(

State

)

ZIP Code

E-mail Address:

Date Available:

Desired Salary:

$

Position Applied for:
YES

NO

Are you a citizen of the United States?

YES

If no, are you authorized to work in the U.S.?
YES

NO

YES

NO

Have you ever worked for this company?

If yes, when?

Have you ever been convicted of a felony?
If yes, explain:

Education
High School:

Address:
YES

From:

To:

College:

Degree:

Address:
YES

From:

To:

Other:

NO

Did you graduate?

Degree:

Address:
YES

From:

NO

Did you graduate?

To:

NO

Did you graduate?

Degree:

References
Please list three professional references.
Full Name:

Relationship:

Company:

Phone:

(

)

Phone:

(

)

Phone:

(

)

Address:
Full Name:

Relationship:

Company:
Address:
Full Name:
Company:
Address:

Relationship:

NO

Previous Employment
Company:

Phone:

Address:

(

)

Supervisor:

Job Title:

Starting Salary:

$

Ending Salary:

$

Responsibilities:
From:

To:

Reason for Leaving:
YES

NO

May we contact your previous supervisor for a reference?
Company:

Phone:

Address:

(

)

Supervisor:

Job Title:

Starting Salary:

$

Ending Salary:

$

Responsibilities:
From:

To:

Reason for Leaving:
YES

NO

May we contact your previous supervisor for a reference?
Company:

Phone:

Address:

(

)

Supervisor:

Job Title:

Starting Salary:

$

Ending Salary:

$

Responsibilities:
From:

To:

Reason for Leaving:
YES

NO

May we contact your previous supervisor for a reference?

Disclaimer and 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.
Signature:

Date:


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