Phone *

(###)

###

####

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Are you at least 18 years old? *

Yes

No

Do you consent to Fairlane Furniture Restorers conducting a full background check on you? *

Yes

No

Do you have a valid drivers license? *

Yes

No

Please select the following number of traffic tickets and/or moving violations you have received in the last three (3) years? *

0 - 1

2

3 or more

Have you had a DUI or DWI in the past five (5) years? *

Yes

No

Have you ever been convicted of, plead guilty, no contest, or nolo contendere to a felony charge? *

Yes

No

Do you have reliable transportation? *

Yes

No

Have you ever been employed by Fairlane Furniture Restorers before? *

Yes

No

Are you currently employed? *

Yes

No

Which of the following schedules are you able to work? *

Normal business hours for full-time team members are Monday - Friday | 8am - 4:30pm

Full-Time

Part-Time

Temporary or Seasonal

When did you start working at your current or most recent employer? *

MM

DD

YYYY

When did you leave your most recent employer?

If currently employed, leave blank.

MM

DD

YYYY

When did you start working at your second most recent employer?

MM

DD

YYYY

When did you leave your second most recent employer?

MM

DD

YYYY

When did you start working at your third most recent employer?

MM

DD

YYYY

When did you leave your second most recent employer?

MM

DD

YYYY

Do you have any of the following? *

High School Diploma

GED

Associates Degree

Bachelors Degree

Masters Degree

Doctoral Degree

None of the above

When did you graduate from the school or university that you attended?

If applicable

MM

DD

YYYY

Do you have a chauffeurs license? *

Yes

No

Do you have a forklift certification? *

Yes

No

Are you able to work evenings or weekends on occasion? *

We periodically perform emergency services work that may require evening and/or weekend shifts | All full-time team members must participate in the on-call shift rotation.

Yes

No

Are you able to lift upwards of 25-50 lbs? *

Yes

No

Which position(s) would you be interested in? *

Packing Team - Primarily road work with some in-plant work - Packing, inventorying, boxing. Cleaning Team - Primarily in-plant work with some road work - Cleaning, boxing, & repacking. Cartage Team - Primarily road work with some in-plant work - Heavy lifting, loading & unloading.

Packing Team

Cleaning Team

Cartage Team

Name *

First Name

Last Name

Phone *

(###)

###

####

Name *

First Name

Last Name

Phone *

(###)

###

####

Applicant's Signature *

First Name

Last Name

Date *

MM

DD

YYYY