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:
yes
no
Are you legally authorized to work in the United States?
yes
no
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?
yes
no
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?
yes
no
If yes, please list
Are you employed?
yes
no
If so, may we inquire of your present employer?
yes
no
Have you ever been convicted of a criminal offense?
yes
no
If yes, please explain, include date, place and conviction(s):
Are there any felony charges pending against you?
yes
no
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:
Employee
Friend
School
Agency
Advertisement
Other
Do you have a current Michigan Driver's License?
yes
no
Why?
Has your license ever been suspended or revoked?
yes
no
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:
yes
no
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:
yes
no
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:
yes
no
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:
Full-Time
Part-Time
Seasonal
Location:
Rate of Pay:
per
hour
week
year
Supervisor:
Reason for Leaving:
Phone Number
Are you eligible for rehire?
yes
no
Date Started:
If no, please explain:
Date Ended :
May we contact this employer?
yes
no
Position / Primary Duties
If no, please explain:
Employer #2
Company Name:
Employment Status:
Full-Time
Part-Time
Seasonal
Location:
Rate of Pay:
per
hour
week
year
Supervisor:
Reason for Leaving:
Phone Number
Are you eligible for rehire?
yes
no
Date Started:
If no, please explain:
Date Ended :
May we contact this employer?
yes
no
Position / Primary Duties
If no, please explain:
Employer #3
Company Name:
Employment Status:
Full-Time
Part-Time
Seasonal
Location:
Rate of Pay:
per
hour
week
year
Supervisor:
Reason for Leaving:
Phone Number
Are you eligible for rehire?
yes
no
Date Started:
If no, please explain:
Date Ended :
May we contact this employer?
yes
no
Position / Primary Duties
If no, please explain:
Employer #4
Company Name:
Employment Status:
Full-Time
Part-Time
Seasonal
Location:
Rate of Pay:
per
hour
week
year
Supervisor:
Reason for Leaving:
Phone Number
Are you eligible for rehire?
yes
no
Date Started:
If no, please explain:
Date Ended :
May we contact this employer?
yes
no
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?
yes
no
If yes, please complete below:
Branch:
Dates of Service
Rank on Discharge:
Special skills or training acquired during service:
Reserve Status:
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