Amended Class Application For Home Improvement Form (Page 2 of 2) in pdf

Experience Information – For Home Improvement Only

4. Complete the following with projects previously completed, that are being requested on page 1.

Example: Residential Remodeler – Houses built, room additions, or large remodel jobs. Or if

requesting Painting; Floors; and Roofing, etc. – show projects where those types of work have been

completed.

Project #1

(Approximate Month & Year)

Date Project Started: ____________ Date Project Completed:____________

Dollar amount of Project: $_____________________ Square Footage (If applicable)____________________

Project Owner’s Name: __________________________________ Contact Phone #: ____________________

Project Address, City, State:_________________________________________________________________

List Specific Type(s) of Work Complete:

________________________________________________________________________________________

Project #2

(Approximate Month & Year)

Date Project Started: ____________ Date Project Completed:____________

Dollar amount of Project: $_____________________ Square Footage (If applicable)____________________

Project Owner’s Name: __________________________________ Contact Phone #: ____________________

Project Address, City, State:_________________________________________________________________

List Specific Type(s) of Work Complete:

________________________________________________________________________________________

Project #3

(Approximate Month & Year)

Date Project Started: ____________ Date Project Completed:____________

Dollar amount of Project: $_____________________ Square Footage (If applicable)____________________

Project Owner’s Name: __________________________________ Contact Phone #: ____________________

Project Address, City, State:_________________________________________________________________

List Specific Type(s) of Work Complete:

________________________________________________________________________________________

Project #4

(Approximate Month & Year)

Date Project Started: ____________ Date Project Completed:____________

Dollar amount of Project: $_____________________ Square Footage (If applicable)____________________

Project Owner’s Name: __________________________________ Contact Phone #: ____________________

Project Address, City, State:_________________________________________________________________

List Specific Type(s) of Work Complete:

________________________________________________________________________________________

(If additional space is needed please attach separately.)

**By signing this form, I agree that all statements herein contained are true and correct, and shall become a

part of the present valid application on file**.

___________________________________________

(Signature of Individual completing application)

Revised 7/2014

Amended Class Application For Home Improvement Form Page 2