Name:


Last_____________________  First____________________  Middle________________

Present address __________________________________________________________________________________________________________________________

Telephone  (     )       -          


are you 18 years of age  _____________________

Position applied for (1) ________________________ and salary desired (2) ________________________ (Be specific)

How many hours can you work weekly? _________________________


Employment desired __ FULL-TIME ONLY __ PART-TIME ONLY __ FULL- OR PART-TIME
When available for work?_______________ 


HAVE YOU EVER BEEN CONVICTED OF A CRIME? __ No __ Yes

If yes, explain number of conviction(s), nature of offense(s) leading to conviction(s), how recently such offense(s) was/were committed, sentence(s) imposed, and type(s) of rehabilitation. _________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________


DO YOU HAVE A DRIVER’S LICENSE? __ Yes __ No
What is your means of transportation to work? _______________________________________________________________

Driver’s license
number ____________________________ State of issue _______

Expiration date ______________________

Have you had any accidents during the past three years?_____________
Have you had any moving violations during the past three years?____________

__ Operator __ Commercial (CDL)

How many? ___________________ How Many? ___________________ 


previous employers.

Position____________________________  Company _____________________________________ Address ______________________________________

Telephone_____________________________________


 Position_____________________________Company_______________________________________Address ___________________________________________

Telephone _____________________________________ 


Education:


High School______________________________

College_______________________

Trade School_______________________

Employment Application 

Send to:

Parker Carpet 

PO Box 2202 Vineyard Haven MA, 02568

jon@parkercarpet.com

Parker Carpets
15C North Line Road Edgartown, MA02539US
Phone: (508) 693-7405 Website: www.parkercarpet.com