Contact Info

First Name

Middile Name Initial

Last Name

Street Address

City

State

Zip Code

Phone Number

Alternate Phone

Email Address

Confirm Email Address

General Info

Are you 18 yers of age or older?

Do you have a work car?

Do you use your own tools?

Do you have a valid california drivers license?

Have you legal right to work in US?

Are you willing to wrok part time?

How many years of experiance do you have?

Any other info you like us to know?

work experiance

What position are you applying for?

If Instaler please continue below

Do you install cerimic tile?

Do you install carpet and carpet tile?

Do you install resilient flooring?

Do you install polish concrete?

Do you have other instalation experience; please explain below

This section only for licensed contractors

What is your businesss name

What is your license number

What type of license your bussiness level

Are you a licensed contractor?

Do you have employees?

Do you have commercial general liability insurence?

Do you have workers compensation insurence?