Job Application - Earthworks Garden Center

Personal information

Today's Date

Name (last, first, middle) *

Date of birth *

Present Address *

Address, City, State, Zip Code

Home Phone *

Cell Phone

Are you a U.S. Citizen or an alien authorized to work in the U.S.?

Yes

No

Email *

Do you have a valid driver’s license? Please Supply Number:

Will you submit to drug testing?

Yes

No

Position Applying For:

Salary Requirement:

Education Background

High School

Name / Address

High School Dates Attended

Graduated?

Yes

No

If Yes, What year did you graduate?

College/University

Name / Address

College/University Dates Attended

College/University Degrees

Trade or Industrial Training

Name / Address

Trade or Industrial Training Degrees/Diplomas

Trade or Industrial Training Dates Attended

Military Service

Branch of Service

Dates of Service

Duties / Special Training

1st Employment History

Starting with most recent. Click "Add" button at the bottom to add more employers (up to 3)

Employer

Start Date

End Date

Address

Phone Number

Supervisor

Beginning Salary

Ending Salary

Primary Duties

Why Did You Leave?

2nd Employment History

Starting with most recent. Click "Add" button at the bottom to add more employers (up to 3)

Employer

Start Date

End Date

Address

Phone Number

Supervisor

Beginning Salary

Ending Salary

Primary Duties

Why Did You Leave?

Add Remove

Personal Information

Starting with most recent

Have you ever been convicted of a crime or had any traffic violations or been imprisoned during the last seven years? A conviction will not necessarily bar you from employment.

Yes

No

If yes, explain.

Names of friends or relatives employed by Earth Works

Did they refer you to apply?

Yes

No

Do you have any physical/mental disabilities that may limit you performance?

Yes

No

If so, what can be done to accommodate your limitation?

1st Professional work references (not friends/family):

List three professional references who are familiar with the quality of your work, have worked directly with you, and have known you at least two years. Click "Add" button at the bottom to add more references.

Reference

Work phone

Home phone

Relationship

2nd Professional work references (not friends/family):

List three professional references who are familiar with the quality of your work, have worked directly with you, and have known you at least two years. Click "Add" button at the bottom to add more references.

Reference

Work phone

Home phone

Relationship

Add Remove

Please answer the following last questions:

Please list all mechanical equipment that you can operate efficiently

Personally or professionally what are you most proud of in your life?

What other types of jobs are you interested in or currently applying for?

Why Earth Works?

What 3 adjectives define you most?

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