Join Our Team ; Employment Application Applicant Information First Name * Last Name * Email * Phone * Street Address City State * AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY Zip Code Length of Time at Address * Driver's License * Yes No Glazier's License * Yes No Position Applying for * Experienced Glazier Glazier Trainee Estimator/Project Manager Glass Technician Other Position Applying for Days and Hours Available to Work * Are you currently legally authorized to work in the United States? * Yes No If hired can you provide proof of age? * Yes No Date available to start? Employment History Provide information for each position held in the past 5 years and explain any gaps in employment. Employer * Employer's Street Address City * State * AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY Zip Code * Job Title * Job Start Date * Job End Date Responsibilities/Duties * Reason for Leaving * May we contact your current/past supervisor? * Yes No Supervisor's Name * Supervisor's Phone # * Supervisor's Email * Add a Position Remove this Position Education, Training, Experience High School/Vocational School School Name * Street Address * City * State AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY Zip Code * High School/Vocational School Start Date * High School/Vocational School End Date * High School /Vocational School Diploma Received? Yes No High School / Vocational School Major Course of Study College College Name Address City State AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY Zip Code College Start Date College End Date College Degree Received Yes No College Degree Type College Major Course of Study Military Branch Military Rank Military Start Date Military End Date List Skills, Licenses, Training Related to Military Position Professional References List 3 professional references from supervisors or co-workers who we may contact and have knowledge of your work performance within the last 5 years. Reference's Full Name * Reference's Phone Number * Reference's Email Address * Reference's Relationship to You * Reference's Company * Reference's Job Title * Years of Shared Work Experience * Add Reference Remove Reference Certification I certify that the statements made by me on this application are true and complete to the best of my knowledge and are made in good faith. I understand that if I knowingly make any misstatement of fact, I am subject to disqualification and dismissal and to such other penalties as may be prescribed by law or personnel regulations. All statements made on this application, including employment information, are subject to verification as a condition of employment. * Date Attach Resume and Cover Letter (Optional) File Upload Drop a file here or click to upload Choose File Maximum upload size: 10MB reCAPTCHA If you are human, leave this field blank. Submit Application