Evergreen

1196 Franklin St. Marne, MI 49435
Phone: 616-677-2300
FAX: 616-677-2302

Snow Services

Personal Information  
Last Name:               First Name:                     Middle Initial:
       
Social Security No.:
Address: City:
State: Zip Code:
Other Names Used in School or for Employment
 
Home Phone Number: Alternate Phone Number:
Are you 18 years of age or older:
Are you legally authorized to work in the United States?
Best time to reach you:
Employment Desired
Position Desired
Classification Desired:
Check all that apply
Full-time Part-time Seasonal Winter Summer
Days of work desired:
Check all that apply
Sun Mon Tues Wed Thurs Fri Sat
When are you available to begin working?
Ever applied to Evergreen Lawn Care & Snowplowing before?
Rate of desired pay: per hour week year
Do you have any relatives or close friends who currently work for Evergreen Lawn Care & Snowplowing, Inc?
If yes, please list
Are you employed?
If so, may we inquire of your present employer?
Have you ever been convicted of a criminal offense?
If yes, please explain, include date, place and conviction(s):
Are there any felony charges pending against you?
If yes, please provide place and charge(s):
How did you happen to apply at Evergreen Lawn Care & Snowplowing? Please select one and provide specific information:
 
Do you have a current Michigan Driver's License?
Why?
Has your license ever been suspended or revoked?
Why?
Drivers License Number:
Current Number of Points:
Education History
High School
Name, Location, Phone Number of School
Years Attended
Major/Area of Study:
Did you Graduate?
If so, please list your degree:
Grade Point Average:
College
Name, Location, Phone Number of School
Years Attended
Major/Area of Study:
Did you Graduate?
If so, please list your degree:
Grade Point Average:
Other
Name, Location, Phone Number of School
Years Attended:
Major/Area of Study:
Did you Graduate?
If so, please list your degree:
Grade Point Average:
Have you attended any continuing education programs related to the job for which you are applying within the past two years? If so, please list below:
 
 Former Employers (List below last four employers, starting with last one first)
Employer #1
Company Name: Employment Status:
Location: Rate of Pay: per
Supervisor: Reason for Leaving:
Phone Number Are you eligible for rehire?
Date Started: If no, please explain:
Date Ended : May we contact this employer?
Position / Primary Duties If no, please explain:
Employer #2
Company Name: Employment Status:
Location:

Rate of Pay:

 per
Supervisor: Reason for Leaving:
Phone Number Are you eligible for rehire?
Date Started: If no, please explain:
Date Ended : May we contact this employer?
Position / Primary Duties If no, please explain:
Employer #3
Company Name: Employment Status:
Location:

Rate of Pay:

 per
Supervisor: Reason for Leaving:
Phone Number Are you eligible for rehire?
Date Started: If no, please explain:
Date Ended : May we contact this employer?
Position / Primary Duties If no, please explain:
Employer #4
Company Name: Employment Status:
Location:

Rate of Pay:

 per
Supervisor: Reason for Leaving:
Phone Number Are you eligible for rehire?
Date Started: If no, please explain:
Date Ended : May we contact this employer?
Position / Primary Duties If no, please explain:
General Information  
Special Skills:
Why do you believe you are qualified for the position for which you are applying?
Do you have any Service in the U.S. Armed Forces or State Militia?
If yes, please complete below:
Branch:
Dates of Service
Rank on Discharge:
Special skills or training acquired during service:
Reserve Status: