Name First Last Address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Date of Birth MM slash DD slash YYYY PhoneEmail What are you doing for work now?How long have you lived in Knoxville?Do you have dependable transportation? Yes No Are you comfortable with heights? Yes No Do you have a smartphone? Yes No Are you able to lift 50 pounds? Yes No Do you have a clean driving record? Yes No What do you like about concrete coating?Give me a brief background and work history?Looking back, what was one of your favorite jobs and why?What is something you consider yourself to be very good at?What management or leadership experience do you have?What is something you consider a weakness or just don’t like?What customer service experience do you have?What do you do when you are stressed out and how do you relieve stress?How much do you need to make? How much do you want to make? Are you willing to work for it?NeedCheck One Hour Week Month Year WantCheck One Hour Week Month Year When I call your references, or previous employer, what will they say, what will all of them say, about you and your work performance?When are you available to start?Ability to work:Have you ever been convicted? Yes No If “YES”, what were you charged with and when?Do you have any physical conditions? Yes No IF “YES”, please describeDo you have any allergies? Yes No Do you smoke? Yes No Do you use drugs? Yes No Are you willing to take a random drug test? Yes No If “NO”, explain why Δ
