Employment

Applicant Information

First Name (required)
Last Name (required)

Street Address (required)
Apartment / Unit #
City (required)
State (required)
ZIP Code (required)

Phone Number (required)
Email Address (required)

Position Applied For (required)
Date Available (required)
Desired Salary

Work Authorization

Are you a citizen of the United States?
YesNo

If no, are you authorized to work in the U.S.?
YesNoN/A

Have you ever worked for Navajo Sandblasting & Painting before?
YesNo

If yes, when?

Have you ever been convicted of a felony?
YesNo

If yes, please explain:Please explain the circumstances...:

Education

High School Name
High School City / State
Years Attended (From – To)
Did you graduate?
YesNo
Diploma / GED

College / Trade School / Other (if applicable)
City / State
Years Attended (From – To)
Did you graduate?
YesNoN/A
Degree / Certificate

Professional References

Please list two professional references.

Reference 1
Full Name (required)
Relationship
Company
Phone

Reference 2
Full Name
Relationship
Company
Phone

Previous Employment

List your two most recent employers.

Previous Employer 1
Company Name
Phone
Address
Supervisor Name
Job Title
Dates Employed (From – To)
Reason for Leaving
ResponsibilitiesBriefly describe your responsibilities...
May we contact this supervisor?
YesNo

Previous Employer 2
Company Name
Phone
Address
Supervisor Name
Job Title
Dates Employed (From – To)
Reason for Leaving
ResponsibilitiesBriefly describe your responsibilities...
May we contact this supervisor?
YesNo

Disclaimer & Acknowledgment

I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.

I agree to the above disclaimer and certify that all information provided is accurate.

Today's Date (required)