Employment Application

Personal Information
* First Name
  

Last Name
 

Street Address
  

City
  

State


Zip Code
  

* Email Address
  


* Phone
 


Position Applied For
  


Do you have any relatives who are presently (or have formerly been) employed by Deals Glass Services? If so please provide name(s):
How were you refered to the company?
Have you ever been convicted of a felony?
  

Yes No
If yes, please explain:

Federal law prohibits the employment of unauthorized aliens. All persons hired must submit satisfactory proof of employment authorization and identity (valid driver's license, birth certificate, Green Card, etc.) within three days of being hired. Failure to submit such proof within the required time shall result in immediate employment termination.

Education History
Please select all levels of education completed and provide name of institution in boxes below:
High school
 


College
  


Tech Training
 


Other
 


Employment Record

Please include all employment for the past five years, starting with the most current.

Company 1
Company Name:
  


City/State:
  


Phone:
  


Position Held:
  


Dates Employed:
  


Manager/Supervisor:
  


Wage/Salary:
  


Reason for Leaving:
  


Company 2
Company Name:
  


City/State:
  


Phone:
  


Position Held:
  


Dates Employed:
  


Manager/Supervisor:
  


Wage/Salary:
  


Reason for Leaving:
  


Company 3
Company Name:
  


City/State:
  


Phone:
  


Position Held:
  


Dates Employed:
  


Manager/Supervisor:
  


Wage/Salary:
  


Reason for Leaving:
  


Company 4
Company Name:
  


City/State:
  


Phone:
  


Position Held:
  


Dates Employed:
  


Manager/Supervisor:
  


Wage/Salary:
  


Reason for Leaving:
  


Company 5
Company Name:
  


City/State:
  


Phone:
  


Position Held:
  


Dates Employed:
  


Manager/Supervisor:
  


Wage/Salary:
  


Reason for Leaving:
  


References

Please do not include relatives or former employees
Name:
  


Address:
  


Phone:
  


Occupation:
  


Years Known:
  


Name:
  


Address:
  


Phone:
  


Occupation:
  


Years Known:
  


Name:
  


Address:
  


Phone:
  


Occupation:
  


Years Known:
  


Work Availability
If your application receives favorable consideration, when will you be available to begin work:

Please check which of the following applies to you:

No objection to working overtime

Can work overtime without prior notice

Can work on Saturdays

Can work on Sundays

Can travel if required by this position

Salary/Hourly Requirements
If your application receives favorable consideration, what salary/hourly rate would you require? Please specify below:
 
Any Additonal Comments