Recruitment Application Form

Glazier Nation LLC

520 Bowens Mill Rd SW, Douglas, GA, 31533

info@glaziernation.com

www.glaziernation.com

(912) 384-2822
Independent Subcontractor

Request For Hire
Personal Information:
Full Name*

First NameMiddle NameLast Name
Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number*
E-mail*
Birth Date*

MonthDayYear
Are you legally entitled to work in the U.S.?*

YesNo
Fluent Languages*
Have you ever worked in Glass & Glazing?*

YesNo
How many years experience *
Current Employer*
Subcontractor:
Have you ever worked for Glazier Nation and/or Glaziers On Demand?*

YesNo
If the above answer was Yes, please list which company you have worked for.*
if none please type "none"
Date You Can Start*

MonthDayYear
Date
What is Your Bid Rate ($)*
OSHA Certified*

YesNo
OSHA

1030Other
Select all the tools you have*

Tool BagHammerRubber MalletChannel LocksVice GripsNeedle Nose PliersDuck Bill PliersCutting PliersAdjustable WrenchBattery ImpactBattery DrillSuction CupUtility KnifeVinyl RollerCartridge Gun25' Tape MeasureFile SetScrew Driver SetPry Bar SetSpeed SquareDust BrushAllen Wrench SetOther
Upload picture of the tools you have *

Please upload one tool for each picture.
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Select all Brands you have worked with*

KawneerOldcastleTubeliteYkkOther
Select all the systems you have installed and/or experience with*

All Glass PartitionsGlazingShower DoorsCanopiesCurtain WallDoor HardwareHandrailsHollow Metal FramesLouverMirrorsPanelsSkylightsStorefrontsDoor EntrancesSunshadesResidential WindowsCommercial WindowsBrake MetalCaulkngVentsOther

Select the appropriate choice for Certification you have*

	YES	NO
Industrial Forklift
Boom Forklift
Aerial Work Platform Lift
Swing Stage
Scaffold
Boom Truck/ Crane

Certifications

Please upload a copy of each certifications you stated above that you have
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Skills/Qualifications:
Skills*
List any relevant skills that you find important to this trade
Qualification:
Qualifications*
List any relevant certifications or qualifications that were not listed above
Showcase your previous Glazing Jobs*

Please upload pictures of any job you have previously worked on. Glazing work only. This allows us to present you for potential jobs in the future, the more the better. We will also need a profile picture for you. Bonus points for you in Glazier gear & PPE.
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Profile Picture Image Upload*

This will be used to showcase you for hire by potential contractors. The image needs to be sharp and clean. No profanity allowed. Bonus points for jobsite photos in PPE Gear. Remember this is how you want to be seen for potential jobs. You want to be viewed as a laborer who will show up ready to work.
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Cover Letter & Resume (Optional):
Resume

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Send Application:
By clicking the submit button below, I cerity that all of the information provided by me on this application is true and complete, and I understand that if any false information, ommissions, or misrepresentations are discovered, my application may be rejected.

In consideration of my Independent Subcontractor hiring, I agree to conform to the company's rules and regulations, and I agree that my Independent Subcontractor status and compenstation can be terminated, with or without cause, and with or without notice, at any time, at either my or the company's option.

I also understand and agree that the terms and conditions of my Independent Subcontractor status may be changed, with or without cause, and with or without notice, at any time by the company.
Date

MonthDayYear
Date
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Cover Letter & Resume (Optional):

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