Repair

Full Name

Phone Number

Email Address

Address (where roofing work is needed)

Position Applying For Position Applying For Roofing Technician Project Manager Sales Representative Estimator Administrative Assistant Other

Availability Availability Full-time Part-time

Previous Employers (Company Name, Job Title, Dates of Employment, Experience)

Highest Level of Education

School Name and Degree

Relevant Skills or Certifications

Name and Contact Information

Authorized to Work in the U.S.? Authorized to Work in the U.S.? Yes No

Felony Conviction Felony Conviction Yes No

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Name

Email Address

Phone Number

Preferred Contact Method Preferred Contact Method Phone Email

Address (where roofing work is needed)

Type of Service Needed Type of Service Needed Roof Repair Roof Replacement New Roof Installation Roof Inspection Emergency Roof Repair

Roof Size Roof Size Small (under 1,500 sq. ft.) Medium (1,500 - 3,000 sq. ft.) Large (3,000+ sq. ft.)

Type of Property Type of Property Residential Comercial

Roof Type Roof Type Asphalt Shingle Tile Metal Flat Roof Other

Current Roof Condition Current Roof Condition Minor Damage (few repairs needed) Moderate Damage (multiple issues) Severe Damage (full replacement likely) Unsure

Description of any known issues or concerns (e.g., leaks, storm damage). Any special requests or questions

Preferred timeframe for the project

How Did You Hear About Us? How Did You Hear About Us? Referral Website Social Media Other