Contractor Application (please print clearly)

Service Provided : Party Rental Items deliverer_____________________________________ _________

Name: _________________________________ SS#: _____________________Date of Birth: _____________

Street Address: ____________________________________________________________________________

City: _________________________________ State: _____ Zip: ___________

Phone: ____________Cell Phone:___________Driver's License Number: _______________ State: _____

Have you ever been convicted of a felony? : YES / NO If yes, explain conviction:_________________

_________________________________________________________________________________________

Education/Qualifications:________________________________________________________________________

_______________________________________________________________________________________________________

Professional Reference: ______________________________________________

Street Address __________________________________ City _______________________State ______ Zip __________

Phone: _________________________

Current Employer: __________________________________________________

Street Address __________________________________ City _______________________State ______ Zip __________

Phone: _________________________

Your Position: _________________________ Supervisor's Name: ___________________________________________

AVAILABILITY: What days are you generally available? Please give specific times

M F  Mornings: (Y/N) ________ Evenings: (Y/N) ________    Sat: Mornings (Y/N) _______Evenings: (Y/N)_______

Sun: Mornings (Y/N) __________ Evenings: (Y/N)_____________

Type of truck: Make ______________ Model__________Size _________

The applicant gives to the employer the right to obtain credit information, public records, criminal records and verify references.

Applicant Signature ________________________________________ Date ________________________

 

Send to:  PMB# 241  -   3336 N. Texas St., Ste J  -  Fairfield, CA 94533