If you are interested in working at J R Glass, please fill out this form and we will get back to you soon. Name Street Address *Apartment Number *City, State & Zip Code *Phone Number *Email Were you referred by someone? If so, Who? What position are you applying for? *Do you have a valid driver's license? YesNoAre you currently employed? YesNoIf you are currently employed, may we contact your current employer? YesNoWhat date can you start? Do you have any special job skills? Most Recent Employer Dates Worked There Example: January 2018 - August 2022Job Description Pay Rate Other Previous Employer Dates Worked There Example: January 2018 - August 2022Job Description Pay Rate Other Previous Employer Dates Worked There Example: January 2018 - August 2022Job Description Pay Rate WebsiteSubmit