Location: Philadelphia, Pennsylvania
It is the policy of Heiler Painting to provide equal employment opportunities to all applicants and employees without regard to any legally protected status such as race, color, religion, creed, age, sex, gender, gender identity, ancestry, national origin, marital status, civil union status, domestic partnership status, veteran’s status, sexual orientation, disability, genetic information, citizenship, or any other protected status. I also understand that Heiler Painting will consider reasonable accommodations for any applicant or employee with a handicap or disability who requests a reasonable accommodation during the application/interview process or during employment.
Applicant Full Name *
Full Address *
Mobile Phone *
Email Address *
Are you 18 years or older? * Make a Selection Yes No
Do you have a valid driver’s license? * Make a Selection Yes No
Do you have a smartphone? * Make a Selection Yes No
What is your preferred contact method? * Make a Selection Text Call
Have you ever been convicted of a felony or violent crime? * Make a Selection Yes No
Highest Level of Education * Make a Selection GED High School Diploma College
How did you hear about us? * Make a Selection Facebook/Instagram Indeed Craigslist Business Card Saw Our Vans Paint Store Friend or Family Member Other
If hired, are you able to submit proof that you are legally eligible for employment in the United States? * Make a Selection Yes No
Job Position Applied For Make a Selection Laborer Skilled Painter Other
Are you able to work weekends if necessary? * Make a Selection Yes No
Desired Salary (e.g $/per hour) *
Desired Start Date *
Applicant Employment History
Employer Name *
Supervisor Name *
Street Address *
State * Make a Selection Pennsylvania Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming District of Columbia Puerto Rico Guam American Samoa U.S. Virgin Islands Northern Mariana Islands
Zip Code *
Job Title *
Reason for Leaving *
Start Date *
End Date *
Can we contact your supervisor? * Make a Selection Yes No
Supervisor Phone Number
Applicant Professional Reference
Phone Number *
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I certify that the information provided on this application is truthful and accurate. I understand that providing false or misleading information will be the basis for rejection of my application, or if employment commences, immediate termination.
I authorize Heiler Painting to contact former employers and educational organizations regarding my employment and education. I authorize my former employers and educational organizations to fully and freely communicate information regarding my previous employment, attendance, and grades. I authorize those persons designated as references to fully and freely communicate information regarding my previous employment and education.
If an employment relationship is created, I understand that unless I am oﬀered a specific written contract of employment signed on behalf of the organization by its CEO, the employment relationship will be "at-will." In other words, the relationship will be entirely voluntary in nature, and either I or my employer will be able to terminate the employment relationship at any time and without cause. With appropriate notice, I will have the full and complete discretion to end the employment relationship when I choose and for reasons of my choice. Similarly, my employer will have the right. Moreover, no agent, representative, or employee of Heiler Painting, except in a specific written contract of employment signed on behalf of the organization by its CEO, has the power to alter or vary the voluntary nature of the employment relationship.
Electronic Signature *
I have carefully read the above certification and I understand and agree to its terms