Employment Application

Personal Information

Date

Full Name

Address

Email

Date of Birth
(if under 18)

Social Security No.

Telephone

Alt Phone

Position applied for

Salary desired

Days/Hours available to work:
No pref
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday

Employment desired
FULL-TIME ONLYPART-TIME ONLYFULL -OR- PART-TIME

When available to start work?

Do you smoke?
YesNo

Are you a citizen of the United States?
YesNo

If no, Are you authorized to work in the U.S.?
YesNo

Education

Did you attend High School?
Yes

What High School?

Did you graduate?
Yes

Did you attend College / University?
Yes

Did you graduate?
Yes

Did you attend Business / Trade School?
Yes

Did you graduate?
Yes

Other (specify)

Criminal Record

HAVE YOU EVER BEEN CONVICTED OF A CRIME?
NoYes

If yes, explain number of conviction(s), nature of offense(s) leading to conviction(s), how recently such offense(s) was/were committed, sentence(s) imposed, and type(s) of rehabilitation.

Driving Record

DO YOU HAVE A VALID DRIVER'S LICENSE?
YesNo

ARE YOU PROFICIENT AT PULLING A TRAILER?
YesNoSomewhat

What is your means of transportation to work?

Driver's license number

Expiration Date

State of Issue

Types of License(s)
OperatorCommercial (CDL)

Have you had any accidents during the past three years?
YesNo

How Many?

Have you had any moving violations during the past three years?
YesNo

How Many?

Landscape Experience

Describe landscaping experience (i.e. lawn installations, irrigation, maintenance, pruning, planting, retaining walls, etc.)

Describe equipment you are familiar with:

Work Experience

Work Experience 1:
Name of Employer:
Address:
City, State, Zip:
Phone:
Last Supervisor Name:
Employment Date Start:
Employment Date End:
Pay/Salary Start:
Pay/Salary End:
Last Job title:
Reason for leaving (be specific):

List the history of the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company.

Work Experience 2:
Name of Employer:
Address:
City, State, Zip:
Phone:
Last Supervisor Name:
Employment Date Start:
Employment Date End:
Pay/Salary Start:
Pay/Salary End:
Last Job title:
Reason for leaving (be specific):

List the history of the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company.

Work Experience 3:
Name of Employer:
Address:
City, State, Zip:
Phone:
Last Supervisor Name:
Employment Date Start:
Employment Date End:
Pay/Salary Start:
Pay/Salary End:
Last Job title:
Reason for leaving (be specific):

List the history of the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company.

References

Reference 1:
Full Name
Company
Position
Relationship
Phone

Reference 2:
Full Name
Company
Position
Relationship
Phone

Reference 3:
Full Name
Company
Position
Relationship
Phone

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