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Employment

Jones Paint and Glass Employment Application

Through UnitedHealthcare, UMR and HealthSCOPE Benefits creates and publishes the Machine-Readable Files on behalf of Jones Paint & Glass. These files are available at: transparency-in-coverage.uhc.com

Step 1 of 7

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Date*
MM slash DD slash YYYY
Legal Name (First, Middle, Last)*
Maiden Name (if applicable)
Other Name(s) Used
Phone*
Secondary Phone
Email*
Present Address*
Street Address Address Line 2 City State ZIP Code
Former Address if less than 5 years at present address or if you lived in another state. Attach sheet if more space is needed.
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Who were you referred by?
Are you 18 years of age or older?*
- Yes
- No
If no, what is your age?
List friends or relatives working for Jones Paint & Glass:
Are you legally authorized to work in the U.S.?*
- Yes
- No
Have you been convicted of a felony or a crime punishable by imprisonment?*
- Yes
- No
Conviction will not necessarily disqualify you for the position for which you are applying.
If yes, please explain:

Employment Desired
Which position(s) are you applying for?*
- Residential Window Installation
- Commercial Window Installation
- Retail Paint Sales
- Window Fabrication
- Automotive Glass Installation/Repair
- Commercial Project Manager
- Estimator
- Outside Sales Paint
- Outside Sales Glass/Window/Shower Doors
- Shipping/Receiving
- Customer Service
- Warehouse
- Other (explain below)
Which location are you applying to?*
Salary Desired*
Are you available to work:*
- Full-Time
- Part-Time
- Shift Work
- Temporary Only
- Summer Only
- Other
If other, please explain:
Have you ever been employed by Jones Paint & Glass?*
- Yes
- No
If yes, please list location and position:
Have you ever applied to Jones Paint & Glass before?*
- Yes
- No
If yes, please list the location you applied to:
If yes, please state when you previously applied:
MM slash DD slash YYYY
Are you currently employed?*
- Yes
- No
Can you work all production shifts if the job requires it?*
- Yes
- No
If no, please explain:
May we contact your current employer?
- Yes
- No
Can you work all days of the week if the job requires it?*
- Yes
- No
If no, what days are you available to work?
Are you currently on layoff status and subject to recall?*
- Yes
- No
Do you have a reliable means of transportation to get to work?*
- Yes
- No
Would you be available for occasional travel?*
- Yes
- No
Do you have a valid driver's license?*
- Yes
- No

Military Information
Leave blank if not applicable
Branch
Dates of duty:
Rank at discharge:
What were your duties? (Include special training and duty station)

Education
Name of High School:*
How many years attended?*
Graduated?*
- Yes
- No
Name of College/University

If more than one, please attach additional information at end of application (included in resume is fine).
Address of College/University
Street Address City State / Province / Region ZIP / Postal Code
How many years attended?
Course or major:
Graduated?
- Yes
- No
Name of Business/Trade School
Address of Business/Trade School
Street Address City State / Province / Region ZIP / Postal Code
How many years attended?
Course or major:
Graduated?
- Yes
- No
Other? Please describe below:
Describe any apprenticeship training or specialized skills you may have:
List professional, trade, business or civic organizations you are affiliated with:
List hobbies, sports, and extracurricular activities you are or have been involved with:

Employment History
List in order of most current or present employer first. Please list employers for at least the last 3 years. If you need more space, please upload in a document at end of application.
Start Date
MM slash DD slash YYYY
End Date
MM slash DD slash YYYY
Employer Name, Address, and Telephone Number:
Last position held:
Start rate of pay:
Finish rate of pay:
Supervisor's name & title:
Reason for leaving:
Briefly describe your role:
Start Date
MM slash DD slash YYYY
End Date
MM slash DD slash YYYY
Employer Name, Address, and Telephone Number:
Last position held:
Start rate of pay:
Finish rate of pay:
Supervisor's name & title:
Reason for leaving:
Briefly describe your role:
Start Date
MM slash DD slash YYYY
End Date
MM slash DD slash YYYY
Employer Name, Address, and Telephone Number:
Last position held:
Start rate of pay:
Finish rate of pay:
Supervisor's name & title:
Reason for leaving:
Briefly describe your role:
Start Date
MM slash DD slash YYYY
End Date
MM slash DD slash YYYY
Employer Name, Address, and Telephone Number:
Last position held:
Start rate of pay:
Finish rate of pay:
Supervisor's name & title:
Reason for leaving:
Briefly describe your role:
Additional Information
Describe any experience, skills, and qualifications that qualify you for a position at Jones Paint and Glass:
Describe the nature of special accommodations you require, if any, in order to perform the essential function of the position for which you are applying.

Experience & Qualifications for Drivers
All applicants for any type of driving position must provide their Motor Vehicle Report for the previous 3 years with their application.
Type of Equipment (CMV, tractor/trailer, van, tank, flat, etc.)
From:
MM slash DD slash YYYY
To:
MM slash DD slash YYYY
Approximate number of miles (total):
Type of Equipment (CMV, tractor/trailer, van, tank, flat, etc.)
From:
MM slash DD slash YYYY
To:
MM slash DD slash YYYY
Approximate number of miles (total):
Type of Equipment (CMV, tractor/trailer, van, tank, flat, etc.)
From:
MM slash DD slash YYYY
To:
MM slash DD slash YYYY
Approximate number of miles (total):
ACCIDENT RECORD FOR PAST 3 YEARS OR MORE (ATTACH SHEET IF MORE SPACE IS NEEDED)
Date
MM slash DD slash YYYY
Nature of accident (head-on, rear-end, upset, etc.)
Date
MM slash DD slash YYYY
Nature of accident (head-on, rear-end, upset, etc.)
Describe fatalities or injuries:
Describe fatalities or injuries:
Describe fatalities or injuries:
Date
MM slash DD slash YYYY
TRAFFIC CONVICTIONS AND FORFEITURES FOR THE PAST 3 YEARS – NO PARKING VIOLATIONS
Location
Date
MM slash DD slash YYYY
Charge
Penalty
Location
Date
MM slash DD slash YYYY
Charge
Penalty
Location
Date
MM slash DD slash YYYY
Charge
Penalty
Have you ever been denied a license, permit, or privilege to operate a motor vehicle?
- Yes
- No
Has any license, permit, or privilege ever been suspended or revoked?
- Yes
- No

Resume & Authorization
Upload Resume or CV
Max. file size: 512 MB.
Upload Cover Letter if Desired
Max. file size: 512 MB.
Additional Files
Max. file size: 512 MB.
Consent
I agree that the information provided in the application is accurate and truthful to the best of my knowledge.
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