T.J. Nelson Home Improvements: Employment Production Application

First Name:
Middle Initial:
City:
State:
Zip:
E-mail: (E-mail)
Yes
No
Address:
Phone Number:
Yes
No
Yes
No
Yes
No
If yes, why?:
Yes
No
   
EMPLOYMENT DESIRED:  
Yes
No
Yes
No
Yes
No
   
EXPERIENCE:
  
Are you able to work by yourself?:
Do you prefer to work with a crew?

What transportation do you have?:
Make of Vehicle
Year of Vehicle:
Is your vehicle reliable?: Yes
No
Driver's License #:
Have you ever had your license taken away?: Yes
No
What skills, activities, studies, research do
you have that would be of added interest?:
Do you have back injuries?: Yes
No
If so what:
Have you ever filed for a Workers Comp. Claim? Yes
No
If so, for what?:
Are you ble to lift up to 50 lbs.?: Yes
No
Have you even been part of the U.S. MILITARY
OR NAVAL SERVICE?:		 Yes
No
Rank:
Present membership in National Guard or Reserves:
   
EDUCATION:  
High School:
No. of years attended:
Did you graduate?: Yes
No
Subjects Studied:
Business School or College:
No. of years attended:
Did you graduate?: Yes
No
Subjects Studied:
   
FORMER EMPLOYERS: List below the last three employers, starting with last one first
Dates:
Name & Address of Employer:
Salary:
Position:
Reason for Leaving:
   
Dates:
Name & Address of Employer:
Salary:
Position:
Reason for Leaving:
   
Dates:
Name & Address of Employer:
Salary:
Position:
Reason for Leaving:
   
Which of these jobs did you like the best?
What did you like most about this job?
   
REFERENCES: Give the names of three persons not related to you, whom you have know atleast one year.
Name:
Address:
Phone:
Years Known:
   
Name:
Address:
Phone:
Years Known:
   
Name:
Address:
Phone:
Years Known:
   
Please fill in any questions that may pertain to you or the position you are applying for.
What types of painting have you done?  
Exterior:
Interior:
How do you feel about being a Laborer?:
Do you have a fear of heights?: Yes
No
How high have you worked outside?:
Have you ever built a scaffolding before?: Yes
No
When?:
What tools of your own do you have available?  
Hand:
Power:
Do you have any drywall experience?:
How much?:
Do you have any experience with wallpaper?: Yes
No
What wallpaper related tools do you have?:
While laboring, do you have any aspects of the building
trades that you won't do? (examples: Insulation, taping,
working in crawl spaces, demolitiong, pouring concrete,
scraping paint):
Do you have any experience with siding and/or vinyl windows?: Yes
No
Do you have any experience with roofing?: Yes
No
Do you have any experience with plumbing/heating?: Yes
No
Do you have any experience with sheet rock?: Yes
No
Do you have any experience with flooring (carpets, vinyl
ceramic, linoleum)?:		 Yes
No
What is your long range career goals?
   
TERMS AND CONDITIONS:  
I Certify that all the information submitted by me on this application is true and complete, and I
understand that if any false information, omissions, or misrepresentations are discovered, my
application may be rejected and, if I am employed, my employment may be terminated at any time.
In consideration of my employment, I agree to conform to the company's rules and regulations, and I
agree that my employment and compensation can be terminated, with or without cause, and with or
without notice, at any time, at either my or the company's option. I also understand and agree that the
terms and conditions of my emoployment may be changed with or without cause, and with or without
notice, at any time by the company. I understand that managerial company representatives, including
the president, has the authority to enter into any agreement for employment for any specific period of
time, or to make any agreement contrary to the foregoing.
 
Date: Check that you agree with the above terms:
 
I, give T.J.N. Enterprises, Ltd. permission to perform
any background check including, but not limited to, a criminal history.
 
Date: Check that you agree with the above terms:
 
Security Code:
Type the characters you see in the picture below.