Marketing Employment Application

Lakeside Exteriors is James Hardie's
#1 Preferred for Home Improvements and Home Remodeling

636-978-5000

Marketing Employment Application

Please fill out the following form to submit your application online. *Asterisks indicate required fields
CONTACT INFORMATION
First Name*
Last Name*
Address line 1*
Address line 2
City*
State*
Zip Code*
Best Number to Reach You* Area Code and Number
Alternate Phone Area Code and Number
Email address*
Referred By
PREVIOUS ADDRESS
Address line 1
Address line 2
City
State
Zip Code
EMPLOYMENT DESIRED
Position Type
Date you can Start*
Salary Desired*
Are you Employed?*		Yes No
If so, may we contact your employer ?*		Yes No
Have you ever applied to us before ?*		Yes No
If so, please tell use where and when
EDUCATION
Grammar School
Did you Graduate?		Yes No
High School
Did you Graduate?		Yes No
Subject Studied
College
Did you Graduate?		Yes No
Subject Studied
Trade, Business or Correspondence School
Did you Graduate?		Yes No
Special Training or Subject Studied
GENERAL INFORMATION
Subjects of special study or special training or skills
PREVIOUS EMPLOYERS
List your last four employers below, beginning with the most recent.
Employer 1
Employer 1 Address
Employment Dates:		From To
Position Held
Salary
Reason for Leaving
Employer 2
Employer 2 Address
Employment Dates:		From To
Position Held
Salary
Reason for Leaving
Employer 3
Employer 3 Address
Employment Dates:		From To
Position Held
Salary
Reason for Leaving
Employer 4
Employer 4 Address
Employment Dates:		From To
Position Held
Salary
Reason for Leaving
REFERENCES
Please list the names of three persons not related to you whom you have known for at least one year.
Name*
Address/Business Name*
Phone Number*
Name
Address/Business Name
Phone Number
Name
Address/Business Name
Phone Number
AUTHORIZATION "By submitting this form I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for dismissal. I authorize investigation of all statements contained herein and the references and employers listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release the company from all liability for any damage that may result from utilization of such information. I also understand and agree that no representative of the company has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing, unless it is in writing and signed by an authorized company representative. This waiver does not permit the release or use of disability-related or medical information in a manner prohibited by the Americans with Disabilities Act 9ADA) and other relevant federal and state laws."

Lakeside Exteriors, Inc. is an Equal Opportunity Employer

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