Careers

Applicant Information

Last Name

First Name

M.I.

Date:

Street Address

Apartment/Unit #

City

State

Zipcode

Phone:

Email Address:

Date Available:

Postion Applied For:

Full Time Part Time

Following Hours/ Days that you are able to work :

Monday

Start (a.m.)

End (p.m.)

Tuesday

Start (a.m.)

End (p.m.)

Wednesday

Start (a.m.)

End (p.m.)

Thursday

Start (a.m.)

End (p.m.)

Friday

Start (a.m.)

End (p.m.)

Saturday

Start (a.m.)

End (p.m.)

Are you a citizen of the United States?

YES NO

If no, enter the type of visa or number which verifies your right to be employed in the U.S.

Type of Visa:

Visa #:

Verified by:

Have you ever worked for Flooring Central?

YES NO

If yes, when?

Education

High School:

Address:

From:

To:

Did you graduate?

YES NO

Diploma:

College:

Address:

From:

To:

Did you graduate?

YES NO

Degree:

Other:

Address:

From:

To:

Did you graduate?

YES NO

Degree:

Previous Employment

Company:

Phone:

Address:

Supervisor:

Job Title:

Responsibilities:

From:

To:

Reason for Leaving:

May we contact your previous supervisor for a reference?

YES NO

References

Please list two professional references.

1) Full Name:

Company:

Relationship:

Phone:

Address:

2) Full Name:

Company:

Relationship:

Phone:

Address:

Disclaimer and Signature

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.

Sign Here:

Clear

Date:

Driver's License

I,

authorize Flooring Central to run my Driver's License.

My Driver's License # :

Address:

Sign Here:

Clear

Date:

Job Application Form

Job Application Form

Applicant Information

Following Hours/ Days that you are able to work :

Education

Previous Employment

References

Disclaimer and Signature

Driver's License

Resume