Employment Application

Name:

Email:

Social Security #:
Date of Birth:

Note: The Age discrimination in employment act of 1967 prohibits discrimination on the basis of age with respect to individuals who are at least 40.

Address:
Phone:

Position Applying For:

Wage/Salary:
Driver License #:    Exp:

Can you perform the work listed below:

Most of our jobs require driving, are physically demanding outside work all day, and require walking, bending, stooping, kneeling, gripping, and lifting heavy objects of at least 60 pounds.

When Can You Start:

Have You ever Been Convicted of a Felony:

Highest Education Level:

Did You Graduate:

Name and Location of School:

Skills/Check all that apply::

Lawn Mowers Weedeaters Aerators Pruning
Hedgetrimmers Blowers Dethatchers Planting
Edgers Power Vacuums Irrigation Spraying

Are you Employed now:

If yes May We Contact Your Employer:

Last 3 Employers Starting with the Most Recent:

Name, Address, Phone, Salary, Manager Name

Employer 1:
Employer 2:
Employer 3:
Personal References:  
References 1:  
Name: Address: Phone:
Reference 2:
Name: Address: Phone:
Reference 3:  
Name: Address: Phone:
Signature:
 

 

 

 

Website created and maintained by

Impression Design