Lewis & Lewis Painting Inc." Home Improvements Plus "

" Where Quality and Prices Meet "

JOB APPLICATION

( Office) Ormond Beach, FL.
(Office) Fort Lauderdale, FL.

AN EQUAL OPPORTUNITY EMPLOYER
It is the policy of Lewis & Lewis Painting Inc to provide employment
opportunities without regard to race, color, religion, sex,
national origin, age, handicap, or veteran status.

APPLICATION FOR EMPLOYMENT
IMPORTANT: please fill in your response above each line unless otherwise indicated.
All answers must be printed or typed. Answers that are illegible or incomplete may
prevent us from considering your application.

PERSONAL DATA

*FIRST NAME *MIDDLE *LAST *SOCIAL SECURITY NUMBER *PRESENT ADDRESS IN FULL *CITY *STATE *ZIP *TELEPHONE PERMANENT ADDRESS (IF DIFFERENT) CITY STATE ZIP TELEPHONE *ARE YOU LEGALLY AUTHORIZED TO WORK IN THE UNITED STATES?
YES
NO
*DO YOU HAVE A VALID DRIVERS LICENSE?
YES
NO
LICENSE NUMBER: STATE: EXPERATION DATE: *HAVE YOU EVER BEEN CONVICTED OF OR SENTENCED FOR ANY VIOLATION OF THE LAW?
YES
NO
IF YES, GIVE FULL PARTICULARS. (THE EXISTENCE OF CRIMINAL RECORD DOES NOT CONSTITUTE AN AUTOMATIC BAR TO EMPLOYMENT):

POSITION INFORMATION

*POSITION APPLIED FOR:
REFERRAL SOURCE:
*ARE YOU WILLING TO WORK OVERTIME, INCLUDING WEEKENDS?
YES
NO

EMPLOYMENT HISTORY

IMPORTANT! STARTING WITH YOUR PRESENT OR MOST RECENT EMPLOYER, LIST IN CONSECUTIVE ORDER ALL EMPLOYMENT. ADDITIONAL EMPLOYMENT MAY BE LISTED ON A SEPARATE PAGE(S) IF NECESSARY.

PREVIOUS EMPLOYER

FULL NAME OF COMPANY TELEPHONE SALARY - FROM/TO EMPLOYED - STREET ADDRESS CITY STATE ZIP CODE NAME & TITLE OF SUPERVISOR TITLE OF YOUR POSITION DEPARTMENT DUTIES
REASON FOR LEAVING

PREVIOUS EMPLOYER

FULL NAME OF COMPANY TELEPHONE SALARY - FROM/TO EMPLOYED - STREET ADDRESS CITY STATE ZIP CODE NAME & TITLE OF SUPERVISOR TITLE OF YOUR POSITION DEPARTMENT DUTIES
REASON FOR LEAVING
* HAVE YOU EVER BEEN SUSPENDED, PLACED ON PROBATION, ASKED TO RESIGN, DISCHARGED OR TERMINATED?
YES
NO
IF YES, PLEASE EXPLAIN:

LEWIS & LEWIS PAINTING INC

APPLICATION FOR EMPLOYMENT

PLEASE READ THIS APPLICATION THOROUGHLY AND COMPLETE IT HONESTLY

IMPORTANT NOTICE: If you need assistance in preparing this application, please contact our office. Applicants should be extremely careful as they complete this application. Lewis & Lewis Painting Inc. is an equal opportunity employer and will not discriminate against any employee or applicant of Lewis & Lewis Painting Inc. Resource Department so that we may address your concerns.

Employment is conditioned upon the successful completion of the screening process. By signing this application, I represent that the information provided in this form is given voluntarily, may be used in filing reports required by state and federal governments and agencies, may be disclosed to others and used for any other purpose not prohibited by law. Lewis & Lewis Painting Inc. requires all individuals who successfully complete the initial employment screening process to submit to drug and alcohol testing during the course of their employment. The result of such (screening/testing) will be initially disclosed to the decision makers for Lewis & Lewis Painting Inc. and may be the basis for (disqualifying any candidate for employment and for) termination during employment. Lewis & Lewis Painting Inc. reserves the right to utilize this information in any way it deems necessary, such as but not limited to civil, criminal, and administrative proceedings, and may any other similar matters. By signing this application, I agree to the foregoing and further agree to hold Lewis & Lewis Painting Inc. harmless from any claims resulting from such (screening/testing) for drug and/or alcohol use.

BACKGROUND INFORMATION:

*Have you ever committed a crime for which you were not arrested or convicted?
YES
NO
If yes, please state the circumstances.

IF EMPLOYED, I agree to conform to the rules and regulations of Lewis & Lewis Painting Inc., and I understand that as a condition of my employment and continued employment, I will be required to submit to and voluntarily agree to submit to any testing for the presence of drugs or alcohol and to submit to any procedure to assess my qualifications for employment. I ALSO AGREE that, if hired, LEWIS & LEWIS PAINTING INC. has the right to terminate my employment at any time with or without cause or notice, and that I have the same right to terminate my employment.

*(initial)

I understand that no manager or representative of Lewis & Lewis Painting Inc., other than the President of Lewis & Lewis Painting Inc., has an authority to enter into any agreement for employment for any specified period of time or make and agreement contrary to the foregoing either now, in the past or the future. I further understand that even an agreement by the President must be in writing and signed by him or her for it to be binding on either myself or Lewis & Lewis Painting Inc. I further understand that this supersedes any prior written or oral understanding and bars any future oral understanding to the contrary.

*(initial)

I ACKNOWLEDGE AND AGREE that if at any time I am subject to any type of discrimination and/or harassment, I will contact Lewis & Lewis Painting Inc. Corporate Human Resources Department immediately to obtain assistance in the resolution of such matters.

* (initial)

I FURTHER ACKNOWLEDGE AND AGREE that any dispute between me and Lewis & Lewis Painting Inc. relating to my employment and/or the separation thereof, which cannot be resolved informally, shall be resolved pursuant to the voluntary labor arbitration rules of the American Arbitration Association (AAA) in Volusia County, Florida by an impartial arbitrator, selected in accordance with such rules, as the exclusive remedy for any such dispute, including but not limited to claims of alleged discrimination. I understand that I must submit any claim to arbitration no later than three hundred sixty five (365) calendar days following that date I became aware of the conduct constituting the alleged claim. I agree to waive my right to a jury trial over any such dispute and agree that failure to timely submit any claim to arbitration shall result in a waiver of the alleged claim. I further agree to waive any and all claims not raised through this procedure. I understand that this provision does not prevent me from filing a charge or complaint of discrimination or unfair labor practices with the local, state, or federal agency.

*(initial)

I HERBY REPRESENT AND WARRANT that I have read and fully understand the foregoing and seek employment under these condition of my own free will in accordance with my own judgment.

*(initial)

NOTE: All applications are required to furbish proof of identity and legal work authorization in order to be considered for employment.

*(initial)

YOUR SIGNATURE WILL BE REQUIRED WHEN YOU COME FOR AN INTERVIEW!

ADDITIONAL INFORMATION

State the number of times you were late arriving for work for reasons unrelated to a disability, your own serious health condition, or to care for child, spouse, parent or dependent grandparent during the last 24 months?

*
*DURING THE LAST 12 MONTHS?
How many times were you disciplined at work during the last 24 months?
By whom and for what was each disciplinary action?*

Please explain in your own words why you want to work for Lewis & Lewis Painting Inc., in what position, and any other information you feel should be considered in connection with your employment application.

OTHER QUALIFICATIONS, SKILLS, AND ABILITIES

US Military Service - list branch, rank attained, dates and nature of discharge?

If employed by us, will you continue to receive other compensation of any kind from another employer or entity for services to be concurrently performed on behalf of that employer or entity?

*
YES
NO

Dishonorable discharge from the Armed Forces will not necessarily be a bar to employment. Factors such as age at the time of the offense, remoteness of the offense and time to rehabilitation will be taken into account in determining the effect on __________________________ suitable for employment.