Employment Jones Paint and Glass Employment Application Step 1 of 7 14% Date* Date Format: MM slash DD slash YYYY Legal Name (First, Middle, Last)*Maiden Name (if applicable)Other Name(s) UsedPhone*Secondary PhoneEmail* Present Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific 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 AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Who were you referred by?Are you 18 years of age or older?*YesNoIf no, what is your age?List friends or relatives working for Jones Paint & Glass:Are you legally authorized to work in the U.S.?*YesNoHave you been convicted of a felony or a crime punishable by imprisonment?*YesNoConviction will not necessarily disqualify you for the position for which you are applying.If yes, please explain: Employment DesiredWhich 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?*Provo GlassProvo PaintAmerican ForkRooseveltCedar CitySt. GeorgeVernalSalary 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?*YesNoIf yes, please list location and position:Have you ever applied to Jones Paint & Glass before?*YesNoIf yes, please list the location you applied to:If yes, please state when you previously applied: Date Format: MM slash DD slash YYYY Are you currently employed?*YesNoCan you work all production shifts if the job requires it?*YesNoIf no, please explain:May we contact your current employer?YesNoCan you work all days of the week if the job requires it?*YesNoIf no, what days are you available to work?Are you currently on layoff status and subject to recall?*YesNoDo you have a reliable means of transportation to get to work?*YesNoWould you be available for occasional travel?*YesNoDo you have a valid driver's license?*YesNo Military InformationLeave blank if not applicableBranchDates of duty:Rank at discharge:What were your duties? (Include special training and duty station) EducationName of High School:*How many years attended?*Graduated?*YesNoName of College/UniversityIf 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?YesNoName of Business/Trade SchoolAddress of Business/Trade School Street Address City State / Province / Region ZIP / Postal Code How many years attended?Course or major:Graduated?YesNoOther? 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 HistoryList 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 Date Format: MM slash DD slash YYYY End Date Date Format: 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 Date Format: MM slash DD slash YYYY End Date Date Format: 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 Date Format: MM slash DD slash YYYY End Date Date Format: 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 Date Format: MM slash DD slash YYYY End Date Date Format: 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 InformationDescribe 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 DriversAll 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: Date Format: MM slash DD slash YYYY To: Date Format: MM slash DD slash YYYY Approximate number of miles (total):Type of Equipment (CMV, tractor/trailer, van, tank, flat, etc.)From: Date Format: MM slash DD slash YYYY To: Date Format: MM slash DD slash YYYY Approximate number of miles (total):Type of Equipment (CMV, tractor/trailer, van, tank, flat, etc.)From: Date Format: MM slash DD slash YYYY To: Date Format: 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 Date Format: MM slash DD slash YYYY Nature of accident (head-on, rear-end, upset, etc.)Date Date Format: 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 Date Format: MM slash DD slash YYYY TRAFFIC CONVICTIONS AND FORFEITURES FOR THE PAST 3 YEARS – NO PARKING VIOLATIONSLocationDate Date Format: MM slash DD slash YYYY ChargePenaltyLocationDate Date Format: MM slash DD slash YYYY ChargePenaltyLocationDate Date Format: MM slash DD slash YYYY ChargePenaltyHave you ever been denied a license, permit, or privilege to operate a motor vehicle?YesNoHas any license, permit, or privilege ever been suspended or revoked?YesNo Resume & AuthorizationUpload Resume or CVUpload Cover Letter if DesiredAdditional FilesConsent I agree that the information provided in the application is accurate and truthful to the best of my knowledge.CAPTCHA
