If you are interested in working at J R Glass, please fill out this form. Applicant Information Name * First Middle Last Current Address * Street address, City, State Phone Number * Email Address Do you have a valid driver's license? Yes No Position Information Desired Position * Desired Salary Date You Can Start * Are you currently employed? * Yes No If yes, may we contact your current employer? Yes No Have you applied to J R Glass before? * Yes No If yes, when? Education History High School Name Did you graduate? Yes No College Name What subject did you study in college? Did you graduate? Yes No Please describe any other skills, education, or training you have Employment History - Most Recent Position Please describe the last job you held. Company Job Title Salary Start Date End Date Responsibilities Reason for leaving Previous Positions Please describe any prior work experience Company Job Title Salary Start & End Dates Reason for Leaving Company Job Title Salary Start & End Dates Reason for Leaving References Name First Last Phone Number Name First Last Phone Number Name First Last Phone Number
