THE PAINT SHOP – HOME INTERIORS AND EXTERIORS INC.

Applicants be advised:

• Drug tests and background checks must be passed in order to be hired
• Proof of identity and employment eligibility are required for hire
• A valid Drivers' License is required if the position requires driving

Aplicant's Information: Your Name: Address: City: State: Zip Code: Home Phone: Cell Phone: E-Mail Address: How did you hear about us? Select Walk-in Paint Store Newspaper Internet Employee (list) Other   Position(s) Applied for What is the best time to call you? Best number to reach you? Select Home Phone Cell Phone Are you legally eligible for employment in this country? Select Yes No Date available to work? Have you submitted an application here before? Select Yes No  - If yes, when? Have you ever been employed here before? Select Yes No  - If yes, when? What is your desired salary range or hourly rate of pay? Do you have any issues with working overtime? Select Yes No  - If yes, please explain: Do you have any issues with driving/traveling to work sites? Select Yes No  - If yes, please explain: Are you able to perform the essential functions of the job for which you are applying (with or without reasonable accommodation)? Select Yes No Not Sure The following questions are not designed to elicit information about an applicant's disability. Please do not provide information about the existence of a disability, particular accommodation, or whether accommodation is necessary. These issues may be addressed at a later stage to the extent permitted by law. Have you ever pleaded "guilty" or "no contest" to, or ever been convicted of a misdemeanor or felony? Select Yes No If yes, please provide date(s) and details: Have you ever been arrested for any matters for which you are out on bail or on your own recognizance pending trial? Select Yes No If yes, please provide date(s) and details: Have you entered into an agreement with any former employer or other party (such as a non-competition agreement) that might, in any way, restrict your ability to work for our company? Select Yes No If yes, please explain: Job History: Starting with your most recent employer, provide the following information: Employer #1 Employer Name Address Telephone Job Title Supervisor Job Duties Start Date End Date Starting Pay Ending Pay Why did you leave? What did you like most about this position? What did you like least about this position? May we contact this employer for a reference? Employer #2 Employer Name Address Telephone Job Title Supervisor Job Duties Start Date End Date Starting Pay Ending Pay Why did you leave? What did you like most about this position? What did you like least about this position? May we contact this employer for a reference? Employer #3 Employer Name Address Telephone Job Title Supervisor Job Duties Start Date End Date Starting Pay Ending Pay Why did you leave? What did you like most about this position? What did you like least about this position? May we contact this employer for a reference? Explain any gaps in your employment: If not addressed on the previously, have you ever been fired or asked to resign from a job? Select Yes No If yes, please explain: In your current or in a prior job, have you ever written instructions or directions to be followed by employees or customers? Select Yes No If yes, please explain: Is there any other job-related information you want us to know about you? Educational Background: Please enter your educational information. School #1 School Years Completed Completed Diploma GED Degree Other GPA/Class Rank Major/Minor School #1 School Years Completed Completed Diploma GED Degree Other GPA/Class Rank Major/Minor School #3 School Years Completed Completed Diploma GED Degree Other GPA/Class Rank Major/Minor References: List name and telephone numbers of three business/work references who are not related to your and are not previous supervisors. If not applicable, list three school or personal references who are not related to you. Enter here 1st references: Enter here 2nd references: Enter here 3rd references: Experience: Please select your skill level for the following: Stucco Repair: Select 0 (no skill) 1 2 3 4 5 (best) Drywall repair and Texture: Select 0 (no skill) 1 2 3 4 5 (best) Spray Experience: Select 0 (no skill) 1 2 3 4 5 (best) Mixing Custom Colors: Select 0 (no skill) 1 2 3 4 5 (best) What else can you do besides painting? Please check all that apply. Staining Lacquer Faux Finish Wallpaper Other Do you have your own tools? Select Yes No Do you have reliable transportation? Select Yes No What do you like most about painting? What do you like least about painting? What is your strongest skill? What do you want to learn more about painting? If we were to ask 3 people about you, what would they say? What do you like to do when you are not painting? Agreement: Please make a selection. I have read and agree to the above statement. Thank you for your interest in The Paint Shop Inc. Once application is received, it will be reviewed. If interested, we will be in touch within 2 weeks.