Employment Application

Date: calendar
I saw this position advertised in:
Your name:
Age(if under 18):
Address:
City, State, Zip:
Phone: Cell:
Position applying for:
Acceptable pay rate:
Are you currently employed? Yes: No:
If yes, may we contact your employer? Yes: No:
Employer’s Phone Number:
Date you are available: calendar
If hired, do you have reliable transportation to work? Yes: No:
How long have you lived in this area:

Education

  City, State Date graduated Major
Mid. School
High School
College
Other

Previous Employment: List the most recent first:

Date-To Employer Pay Rate Reason for leaving

What would you change about your previous supervisor’s management style?
Do you have any skills, qualifications, or experiences which you feel would qualify you for this employment?
Sneller’s Landscaping usually works 5 days/week. Occasionally, we may work 6 days. Explain any limitations on hours
Do you have any impairments (physical, mental, or medical) which would interfere with your ability to do the job for which you are applying?
Yes: No: If Yes, please describe
Have you ever been compensated for a work related injury?
Yes: No: If Yes, please explain
Are you presently under a doctor’s care?
Yes: No: If Yes, please explain
Have you ever been convicted of a crime?
Yes: No: If Yes, please explain when, where, and the nature of ALL criminal convictions
Are there any felony charges pending against you now?
Yes: No: If Yes, please describe

References - Do not list relatives

Name & Address Phone Years Known Occupation

Driver’s License No:
Number of tickets in the last 5 years:
Number of points against license:
I affirm that all information contained in this application is true and complete. I understand that any falsification, misrepresentation, or omission herein may result in immediate dismissal from or refusal of employment. I authorize the verification of all information and statements made in this application
I understand that my employment and compensation can be terminated with or without cause, with or without notice at any time, at the option of either myself or Sneller’s Landscaping.
SIGNATURE (Type your name)