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Employment Application Form
PLEASE COMPLETE ALL PAGES
Date __________________________________
Name _____________________________________________________________________________________________
Present address _____________________________________________________________________________________
Number Street City State Zip
Date of Birth ____________________ (If under 18)
Social Security No. _______ – _____ – _________
Telephone ( ) Alt. Phone: ( )
Position applied for: __________________________
Salary desired: _____________________________
Days/hours available to work
No Pref ______ Thur _________
Mon _________ Fri __________
Tue _________ Sat __________
Wed _________ Sun _________
Employment desired FULL-TIME ONLY PART-TIME ONLY FULL- OR PART-TIME
When available for work? _______________ Do you smoke? Yes No
Are you a citizen of the United States? Yes No If no, are you authorized to work in the U.S.? Yes No
High School?
Did you graduate?
Yes No
College / University
Did you graduate?
Yes No
Business / Trade School
Did you graduate?
Yes No
Other (specify):
____________________________________________________________________________________________
HAVE YOU EVER BEEN CONVICTED OF A CRIME? No Yes
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. _________________________________________________
DO YOU HAVE A VALID DRIVER’S LICENSE? Yes No
ARE YOU PROFICIENT AT PULLING A TRAILER? Yes No Somewhat
What is your means of transportation to work? ______________________________________________________________
Driver’s license
number ____________________________ State of issue _______ Operator Commercial (CDL)
Expiration date ______________________
Have you had any accidents during the past three years? Yes No
How many? ___________________
Have you had any moving violations during the past three years? Yes No
How Many? ___________________
Describe landscaping experience (i.e. lawn installations, irrigation, maintenance, pruning, planting, retaining walls, etc.)