Application For Employment

Application For Employment

First Name*
Middle Name*
Last Name*
Residence Address*
Street Address City State ZIP Code
Home Phone
Cellular Phone
Are you legally authorized to work in the United States?*
What type of work are you applying?*
Are you able to perform the essential functions of the position(s) you are applying for with or without reasonable accommodation?*
Are you 18 years of age or older?*
How were you referred for employment?*
Name of Referral Source
Other
List any friends or relatives employed by Pacific Green Landscape, Inc. & their relationship to you.
Have you ever been employed by Pacific Green Landscape, Inc.?*
Dates
MM slash DD slash YYYY
Education
High School or Institution Name
Diploma or GED?
Location Address
Street Address City State ZIP Code
Advanced Education – College, University or Vocational/Technical Applicants will be asked to furnish transcripts of school or college work where appropriate
Name of Institution
Did You Graduate?
Location Address
Street Address City State ZIP Code
Dates Attended
Dates Attended
Degree or Certificate Granted
Credits
GPA
Major/Minor or Course of Study
Awards, Certificates, Special Training:
Military
US Military Service
Have you separated?
Branch
Rank
Reserve Status
Special Military Training:
Work History
Give employment history as completely as possible, starting with your present or most recent employer. For any unemployment periods, show dates and location. Include U.S. Military Service, if any.
Most Recent Employer
Company
Business Phone
May we contact you here?
Dates of Employment
From
To
Business Address
Street Address City State ZIP Code
Supervisor Information
Supervisor’s Name
Supervisor’s Title
Supervisor’s Phone
May we contact your supervisor?
Your Title
Responsibilities
Hidden
Section Break
1st Previous Employer
Company
Business Phone
May we contact you here?
Business Address
Street Address City State ZIP Code
Supervisor Information
Supervisor’s Name
Supervisor’s Title
Supervisor’s Phone
May we contact your supervisor?
Your Title
Responsibilities
Hidden
Section Break
2nd Previous Employer
Company
Business Phone
May we contact you here?
Business Address
Street Address City State ZIP Code
Supervisor Information
Supervisor’s Name
Supervisor’s Title
Supervisor’s Phone
May we contact your supervisor?
Your Title
Responsibilities
Hidden
Section Break
Have you ever been discharged from any job?
If yes, please explain
Reference 1
Name
Occupation
Phone
Address
Street Address City State ZIP Code
Hidden
Section Break
Reference 2
Name
Occupation
Phone
Address
Street Address City State ZIP Code
Hidden
Section Break
Reference 3
Name
Occupation
Phone
Address
Street Address City State ZIP Code
Pre-employment Statement*
PRE-EMPLOYMENT STATEMENT
I certify that the information given by me in this application is true and correct without omissions of any kind. I authorize an inquiry to be made into the information contained in this application if I am considered for employment. I understand that Pacific Green Landscape, Inc. may request me to submit to a pre-employment/post-offer medical examination and drug and alcohol screening tests and I hereby agree and consent to such examination and testing.

I hereby authorize the company to make a complete investigation into all aspects of my background and hereby release the company form any liability in any way connected with that investigation. I also authorize the company to maintain any records related to that investigation. Former employers, educational institutions and references named herein are authorized to give information about me. I hereby release them from all liability for issuing such information. I hereby wave any privilege I have to such information.

I understand that employment is contingent upon me submitting documentary proof of identity and illegal authorization to work in the United States as required.

I understand and acknowledge that if any misrepresentation or omission of facts have been made by me, or if the results of an investigation are not satisfactory for any reason, any consideration, offer, or actual employment by the company may be terminated immediately without obligation or liability to me other than payment at the rate agreed upon, for service actually rendered, if any.

I understand that nothing contained in this employment application or in the granting of an interview, and no company policies, procedures, or handbooks that I might receive, are intended to create an employment contract between the company and myself for a specific length of time or under which I can only be terminated for good cause. I understand that nothing contained in this employment application or in the granting of an interview, and no company policies, procedures or handbooks that I might receive are intended to create an employment contract between the company and myself limiting the company’s right to transfer, demote, suspend or administer employee discipline. No promises regarding employment have been made to me and I understand that no such promise or guarantee is binding upon the company unless made in writing by an authorized company representative.

If an employment relationship is established, I understand that the company and I have the right to terminate my employment at any time for any reason. I further understand that if an employment relationship is established, the company retains the absolute right to transfer, demote, or administer employee discipline at any time for any reason. This at-will agreement will remain in effect throughout the duration of my employment and may only be changed by a written agreement signed by me and the President of the company.
- I agree to the pre-employment statement above.