Mystic River Paintworks, LLC
Stonington, CT 06378
(860) 535-4415
                              Applicants are considered for all positions without regard to race, color, religion,
                              age, sex, marital status, national origin, veteran status, sexual orientation, or the
                              presence of a non-job related medical condition, disability or handicap.
                              It is company policy to provide a non-smoking work environment for all employees.
                              Smoking is not permitted in company offices or common areas of the building.
                              Thank you for completing this application form and for your interest in employment
                              with our company. Employment will be subject to satisfactory reference checks and
                              a pre-employment examination that will include a drug and alcohol screening
                              in accordance with state and federal law.
APPLICATION FOR EMPLOYMENT
PERSONAL
Name:
 Phone number:
Street address:
 City, state zip:
Social Security No.:
(Optional)
 Email address:
Position Applied for:
 Salary Desired:
Source of Referral:
Date Available:
EDUCATION
School
Name & Location
Course of
Study
# of Years
Completed
Did You Graduate?
Degree or
Diploma?
College
High School
Other
US MILITARY SERVICE
Branch of Service
Rank & Type of Service
Training/Experience
Received
EMPLOYMENT EXPERIENCE
(Start with present or most recent employer)
 
Employer Address &
Telephone No.:
Supervisor:
Job Title &
Work Performed:
Reason for
Leaving:
Dates Employed &
Hourly Rate
Employer
Employer
Employer
Employer
SPECIAL SKILLS & QUALIFICATIONS
- Summarize special skills, qualifications, licenses, hobbies, professional, business or civic
experiences that you think would especially qualify you for employment. (You may
exclude those which indicate race, religion, sex or national origin) -
REFERENCES (other than relatives)
Name:
Home Address:
Phone:
Occupation:
Years Known:
    •  I understand that employment will be subject to my submitting documentary proof
        of my identity and legal eligibility to work.
    •  I understand that the employer follows an “employment at will” policy, in that I or
        the employer may terminate my employment at any time or for any reasons consistent
        with applicable state or federal law.
    •  I understand that this application is not a contract of employment.
    •  I understand that the company will thoroughly investigate my work and personal history
        and verify all data given on this application, on related papers, and in interviews. I authorize
        all individuals, schools, and firms named therein, except my current employer if so noted, to
        provide any information requested about me, and I release them from all liability for damage
        in providing this information.
    •  I certify that all the statements herein are true and understand that any falsification or
        willful omission shall be sufficient cause for dismissal or refusal of employment.
Electronic Signature:
Electronic Date:
All rights reserved.