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 timesM– 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
