Job Application Name* First Last Are you authorized to work in the United States?* Yes No Are you 18 years or older?* YesNo Do you have a valid driver's license?* YesNo Do you have dependable transportation?* YesNo Current address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Length of time at this address?* Previous address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Length of time at this address?* Cell phone #* (Note: you will need a smart phone if accepted for employment) Your email address:* (Note: you will need an email address if accepted for employment) Position applied for:* Entry level (laborer, helper, trainee) Painter Wall paper Hanger Other Rate of pay expected:* Do you want to work:* Full-time Part-time If hired, when would you be able to start work?* Date Format: DD dash MM dash YYYY Have you ever applied for work with T. L. Hart, Inc. before?* Yes No If yes, when? List anyone you know who works for T. L. Hart, Inc. Are you able to perform all the essential functions and duties required for the position for which you are applying, with or without reasonable accomodations?* Yes No If no, how would you perform these essential functions and duties, and with what accomodations? Have you ever been convicted of a felony, or are there any felony charges pending against you?* Yes No If yes, please list the date, place, and nature of conviction: What type of skills, qualifications, or experiences do you have which would benefit us in hiring you?* Please rate your skill level, with 1 being unskilled and 5 representing journey-person level:* 1 - Unskilled 2 3 4 5 - Journey-person Did you graduate from high school?* Yes No If yes, list name of high school plus city and state in which it is located:* Have you any college or trade school?* Yes No If yes, list name of college or trade school plus city and state in which it is located:* Please list your employment history, beginning with your current or most recent job, listing the name of the company, the city and state in which it is located, the dates you were employed there, the name and phone number of the contact person, and the reason you are no longer employed there:* Please list 3 personal (non-family) references and their phone numbers, people who can attest to your character and work ethic:* YOUR CERTIFICATION AND AGREEMENT - PLEASE READ CAREFULLY BEFORE SIGNING: I certify that all statements made on this application form are correct and I understand that any false statements will be sufficient cause for rejection of my application or sufficient cause for discharge if I am hired. I grant the company permission to investigate any of the information given on this application form. I understand that the use of this form does not indicate that there are positions open and does not in any way obligate this company. Further, I understand and agree that if hired by this company, unless specifically set forth in writing to the contrary and signed by the President, my employment will be for no definite period, and may, regardless of the date of payment of my wages or salary, be terminated at any time for any reason at the will of the company without any previous notice. I understand that any offer of hire is completely contingent upon giving my written permission for, and successfully passing a physical and drug test performed by an occupational health supplier. I further understand that I must possess a valid driver’s license. T. L. Hart, Inc. is an equal opportunity employer. It is our policy that all applicants be considered solely on the basis of qualifications and ability, without regard to race, religion, color, sex, age, national origin, disability, height, weight, marital status, or veteran status. I agree that any claim or lawsuit arising from or related to my application for and/or employment with T. L. Hart, Inc. or any of its subsidiaries must be filed no more than six (6) months from the date of the employment action that is the subject of the claim or lawsuit. I hereby waive any statute of limitations to the contrary. If you agree, sign by typing in your name below:* Date* Date Format: DD dash MM dash YYYY Phone This field is for validation purposes and should be left unchanged.
