Name*

Email*

Address*

Phone*

Position(s) Applied For

Available Start Date

Are you over 18 years of age?
Yes No

If hired, proof of your identity and employment eligibility in the United States much be established by appropriate documentation at the time you begin work at Coastal Canvas Products.*
Yes No

Have you ever been convicted of a violation of the law other than a minor traffic violation?*
Yes No

If yes, please explain.

Have you ever applied to work with Coastal Canvas Products before?*
Yes No

If yes, when?

Are you willing to work an irregular schedule, overtime, and on weekends if necessary?*
Yes No

If no, please explain.

Do you have adequate transportation to travel to and from work?*
Yes No

If no, please explain.

Can you perform the essential function of the position (see attached job description) with our without reasonable accommodation?*
Yes No

Education

High School Name Number of Years Completed

College Name Number of Years Completed

Other Name Number of Years Completed

Employment History (most recent employment first)

1.

Date Employed From: Date Employed To: Employers Name Employers Address Employers Phone Number Position Held Hourly Wage Reason for Leaving

2.

Date Employed From: Date Employed To: Employers Name Employers Address Employers Phone Number Position Held Hourly Wage Reason for Leaving

3.

Date Employed From: Date Employed To: Employers Name Employers Address Employers Phone Number Position Held Hourly Wage Reason for Leaving

4.

Date Employed From: Date Employed To: Employers Name Employers Address Employers Phone Number Position Held Hourly Wage Reason for Leaving

US Military Service

Branch

Highest Rank Achieved

Dates of Service

Duties

Other Experience or Qualifications

Certification & Authorization

Please read thoroughly.

I certify that all facts contained in this employment application are true and complete and acknowledge that Coastal Canvas Products is relying on the accuracy of the information provided. I authorize Coastal Canvas Products to verify the accuracy of the information provided herein, and I authorize former employers, education institutions and credit agencies to release information concerning me to Coastal Canvas Products. I also authorize Coastal Canvas Products to give references and provide information about me in response to inquiries subsequent to my employment if hired. I understand and agree that, if hired, my employment will be for no definite period and may, regardless of the date of payment of wages, be terminated at any time without previous notice and with or without reason, at the will of either myself of Coastal Canvas Products. I also understand and agree that no one has authority to promise me job security or continued employment, except the CEO of the Company in a formal written agreement signed by both of us.*

Employment Opportunities

Application for Employment

Education

Employment History (most recent employment first)

1.

2.

3.

4.

US Military Service

Certification & Authorization

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