Note - There is a PDF document at the bottom of this page if you'd prefer to fill it out and email or bring it in.

Name (Last, First, Middle Initial)

Phone Number

Email Address

Street/Mailing Address, City, State, Zip

Street: City, State: Zip:

Please check all that apply

I have a valid driver's license
I have a high school diploma or GED
I am able to lift heavy objects
I am mechanically inclined (able to fix and understand how things work)
I have a high level of attention to detail
I am self-driven and able to work alone without direct supervision
I have good communication skills
I have 3 or more years working as a glazier (not required)
I have 3 or more years working in construction (not required)
I have 3 or more years working in remodeling (not required)
I am authorized to work in the U.S. on an unrestricted basis

Date you can start work

Desired Hourly Pay

Have you ever been convicted of a felony? (Convictions will not necessarily disqualify an applicant from employment)

Yes
No

If "Yes" to the above question, please explain

Qualifications (education or training you feel relates to the position that would help you perform the work, such as schools, colleges, degrees, etc.))

Special Skills (list any special skills or experience that you feel would help you in the position: leadership, organizations/teams, etc.)

References: please list 3 professional references not related to you. If you don't have 3 professional references, then list 3 personal unrelated references

Reference #1 (Name, Address/City/State, Phone, Relationship to you)

Name: Address: City, State: Phone: Relationship:

Reference #2 (Name, Address/City/State, Phone, Relationship to you)

Name: Address: City, State: Phone: Relationship:

Reference #3 (Name, Address/City/State, Phone, Relationship to you)

Name: Address: City, State: Phone: Relationship:

WORK HISTORY: start with your present or most recent employment and work back

May we contact your present employer?

Yes
No
N/A

Job Title #1, Company, City/State/Zip, Duties, Supervisor's Name, Phone Number, Start Date, End Date, Starting Salary, Ending Salary, Reason for Leaving

Job Title: Company: City/State/Zip: Duties: Supervisor's Name: Phone: Start Date: End Date: Starting Salary: Ending Salary: Reason for Leaving:

Job Title #2, Company, City/State/Zip, Duties, Supervisor's Name, Phone Number, Start Date, End Date, Starting Salary, Ending Salary, Reason for Leaving

Job Title: Company: City/State/Zip: Duties: Supervisor's Name: Phone: Start Date: End Date: Starting Salary: Ending Salary: Reason for Leaving:

Job Title #3, Company, City/State/Zip, Duties, Supervisor's Name, Phone Number, Start Date, End Date, Starting Salary, Ending Salary, Reason for Leaving

Job Title: Company: City/State/Zip: Duties: Supervisor's Name: Phone: Start Date: End Date: Starting Salary: Ending Salary: Reason for Leaving:

Job Title #4, Company, City/State/Zip, Duties, Supervisor's Name, Phone Number, Start Date, End Date, Reason for Leaving, Starting Salary, Ending Salary

Job Title: Company: City/State/Zip: Duties: Supervisor's Name: Phone: Start Date: End Date: Starting Salary: Ending Salary: Reason for Leaving:

Click to enter text

I certify that the facts set forth in this Application are true and complete to the best of my knowledge. I understand that if I am employed, false statements, omissions or misrepresentations may result in my dismissal. I authorize KanView Glass to make an investigation of any of the facts set forth in the application and release KanView Glass from any liability. KanView Glass may contact any listed references on this application.
I certify that this application was completed by me, with my name and information listed above, and not by any other representation. 
I acknowledge and understand that KanView Glass is an "at will" employer. Therefore, any employee may resign at any time, just as KanView Glass may terminate the employment relationship at any time, with or without cause, with or without notice to the other party.

By continuing, you agree to the above statements.