w.w. NASH Companies

Fireproofing, Wall-Covering, Acoustical Solutions, Commercial Painting

1400 Brook Road // Richmond VA 23220

w.w. NASH Construction: 804-788-9122

w.w. NASH & Sons: 804-788-9011

w.w. NASH Companies

w.w. NASH & sons, inc.

Employment Application

1400 Brook Road, Richmond, VA 23220

804-788-9011

wwnash.com

Applicant Information

Full Name*
Address*
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Zip*
Phone*
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    Email*
    Start Date or Date Available*
    Date of Birth*
    Place of Birth*
    Social Security Number*
    Hourly Rate Requested
    Position Applied for:*
    Are you a citizen of the United States?*
    Yes
    No
    Have you ever worked for this company?*
    Yes
    No
    If yes, when?
    If no, are you authorized to work in the U.S.?*
    Yes
    No
    Have you ever been convicted of a felony?*
    Yes
    No
    If yes, explain?

    Previous Employment

    Company:
    Address:
    Phone:
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      Supervisor:
      Job Title:
      Starting Salary:$
      Ending Salary:$
      Responsibilities:
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      Company:
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        Supervisor:
        Job Title:
        Starting Salary:$
        Ending Salary:$
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        From:
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        May we contact your previous supervisor for a reference?
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        Company:
        Address:
        Phone:
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          Supervisor:
          Job Title:
          Starting Salary:$
          Ending Salary:$
          Responsibilities:
          From:
          To:
          Reason for Leaving:
          May we contact your previous supervisor for a reference?
          Yes
          No

          military service

          Branch:
          From:
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          Rate at Discharge:
          Type of Discharge:
          If other than honorable, explain:

          MOre information

          Are you available to work night?
          Yes
          No
          Are you available to work weekends?
          Yes
          No
          Do you have reliable transportaion to work?
          Yes
          No
          Do you have a valid driver's license?
          Yes
          No
          Have you had a recent respirator physical? If so, can you provide copy of the results?
          Yes
          No
          Have you ever been tested for lead exposure?
          Yes
          No
          Do you have any formal training in the painting industry?
          Yes
          No
          Are you available to work out of town for extended periods of time?
          Yes
          No
          Are you able to work more than 8 hours per day?
          Yes
          No
          Do you speak fluent English?
          Yes
          No

          MOre information

          Do you have any physical, mental or other health conditions that may affect your job or compromise safety? i.e. High blood pressure, bad back, hernia, etc. If so, please explain
          Have you ever been injured on the job? If yes, please describe
          Please list any experience and certifications you have in the construction industry i.e. Aerial platform, OSHA Training, 1st Aid/CPR, etc.

          Disclaimer and signature

          I certify that my answers are true and complete to the best of my knowledge.
          If this application may lead to employment, I authorize W W Nash to perform a background check using this information.
          I understand that false or misleading information in my application or interview may result in my release.

          By checking this box and typing my name below, I am electronically signing my application.*
          Signature: *
          Date:
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