Gilinspex - Central Indiana's Source for Quality Home Inspection

EMPLOYEE APPLICATION

Please fill in as much information as you have available to assists us with our scheduling and pricing of the inspection. Be sure to fill in name and contact information so we can get back to you, even if you do not want to fill out the rest of the form.

PERSONAL INFORMATION
First Name:
Last Name:
Street:
City:
State:
Zip:
Home Phone:
Email:

COMPANY INFORMATION
Company/Business Name:
Company Street:
Company City:
State:
Zip:
Position/Title:
Work Phone:
Cell Phone:
Pager:
Fax:
Are You Self-Employed?	Yes No
If Yes, How Is Your Company Structured?	Sole Proprietorship Partnership Corporation Franchise Other
How Do You Conduct Inspections?	Part Time Full Time
Years Conducting Inspections:
Years Company Has Been In Business:
Annual Inspection Volume:
Average Inspection Fee:
Approximate The Percentage Of Business You Have From The Following Sources	Real Estate Agents Client Referrals Relocation Companies Home Buyers Attorneys Other
Describe Your Training Program:
Describe The State Certification Program:
Other Training Information:

INSPECTION CERTIFICATION
Affiliation #:
Termite/Pest Control:	State Certification or License #:
General Home Inspection:	State Inspection #:
Radon Inspection:	NEHA #: NRSB #: State Certification #:
Structural Engineering:	P.E. License #:
Other Professional Associations:
Related Experience:	Contracting
Related Experience:	Other

EDUCATION
Schools: Degree: Years:


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