First Name *

Last Name *

Phone *

Email *

Address

Street Address *

City *

State *

Are you over 18? *

Yes

No

Can you lift and carry 50lbs? *

Yes

No

Are you comfortable working on ladders and roofs? *

Yes

No

Do you have any upcoming travel or commitments that might affect your availability through December? *

Yes

No

List the dates you can not work.

What days and hours are you available to work during the holiday season? *

What steps would you take if you noticed a co-worker doing something unsafe on a ladder? *

Do you have any restrictions that would prevent you from safely performing the essential duties of this job? *

Yes

No

Briefly explain.

Do you have a valid driver's license? *

Yes

No

Reliable Transportation? *

Yes

No

Describe any related work experience. (i.e. roofing, tree work, etc.)

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