*denotes required fields

DATE:

DATE AVAILABLE:

EMAIL*:

PERSONAL DATA

LAST NAME*:

FIRST NAME*:

MIDDLE NAME*:

ADDRESS*:

TELEPHONE*:

CITY*:

STATE*:

ZIP CODE*:

POSITION DESIRED:

SALARY DESIRED:

HOURS AVAILABLE:

WILLING TO WORK OVERTIME? YesNo

ARE YOU LEGALLY ABLE TO WORK IN THE U.S.? YesNo

HAVE YOU BEEN EMPLOYED HERE BEFORE? YesNo

ARE YOU A PREVIOUS APPLICANT? YesNo

ARE YOU OVER THE AGE OF 18?YesNo

WORK EXPERIENCE

Start with most recent position: furnish dates and explanation for each period of employment and unemployment for the last 5 years. Use a separate sheet, if necessary.

PRESENT/LAST EMPLOYER:

TYPE OF BUSINESS:

ADDRESS:

TELEPHONE:

START DATE/LEAVE DATE:

HOURLY RATE OF PAY:

REASON FOR LEAVING:

JOB TITLE:

SUPERVISOR AND TITLE:

MAY WE CONTACT: YesNo

DESCRIBE RESPONSIBILITIES:

PREVIOUS EMPLOYER:

TYPE OF BUSINESS:

ADDRESS:

TELEPHONE:

START DATE/LEAVE DATE:

HOURLY RATE OF PAY:

REASON FOR LEAVING:

JOB TITLE:

SUPERVISOR AND TITLE:

MAY WE CONTACT: YesNo

DESCRIBE RESPONSIBILITIES:

PREVIOUS EMPLOYER:

TYPE OF BUSINESS:

ADDRESS:

TELEPHONE:

START DATE/LEAVE DATE:

HOURLY RATE OF PAY:

REASON FOR LEAVING:

JOB TITLE:

SUPERVISOR AND TITLE:

MAY WE CONTACT: YesNo

DESCRIBE RESPONSIBILITIES:

PREVIOUS EMPLOYER:

TYPE OF BUSINESS:

ADDRESS:

TELEPHONE:

START DATE/LEAVE DATE:

HOURLY RATE OF PAY:

REASON FOR LEAVING:

JOB TITLE:

SUPERVISOR AND TITLE:

MAY WE CONTACT: YesNo

DESCRIBE RESPONSIBILITIES:

WORK EDUCATION AND TRAINING

Please complete all appropriate items.

TYPE OF SCHOOL

NAME AND LOCATION OF SCHOOL

DEGREE EARNED

MAJOR/MINOR FIELDS OF STUDY

HIGH SCHOOL

DIPLOMA? YesNo

BUS. OR TECH

DIPLOMA? YesNo

COLLEGE

DIPLOMA? YesNo

OTHER

DIPLOMA? YesNo

PROFESSIONAL REFERENCES

List 3 professional references. (DO NOT LIST RELATIVES OR PERSONAL FRIENDS)

NAME

TELEPHONE

ADDRESS

RELATIONSHIP

APPLICANT STATEMENT

Please read carefully: I hereby authorize Landscape Renovations, Inc. (“LRI”) to contact, verify and obtain the accuracy of the information contained in this application from all previous employers, educational institutions, and references. I also hereby release from liability LRI and its representatives for seeking, gathering and using such information to make employment decisions along with all other persons or organizations who are providing such information. I understand that any misrepresentation or material omission made by me on this application will be sufficient cause for cancellation of this application or immediate termination of employment if I am employed, whenever the misrepresentation or omission may be discovered. If I am employed, I acknowledge that there is no specified length of employment and that this application with LRI does not constitute an agreement or a contract for employment. I also acknowledge that I can terminate the employment relationship at will as well as LRI with or without cause, at any time. I understand that it is the policy of LRI not to refuse to hire or otherwise discriminate against qualified individuals with disabilities because of that person’s need for a reasonable accommodation as required by the ADA (Americans with Disabilities Act). I also understand that if I’m employed, I will be required to provide satisfactory proof of identity and legal work authorization within 3 days of being hired. Failure to submit such proof within the required time shall result in immediate termination of employment. I also understand that the LRI has a drug and alcohol policy that provides for pre¬employment testing as well as testing after employment and that consent to and compliance with the Policy is a condition of my employment and continued employment is based on the passing of testing done under this Policy. If I’m employed, in consideration of my employment, I agree to conform to LRI’s rules, ethics, policies and procedures. I represent and warrant that I have read and fully understand the foregoing information and that I seek employment with LRI under these conditions.

By Checking this box I agree agree to the above
I agreeI do not agree

*Note: The Company does not discriminate against any employee or applicant on the basis of race, color, religion, creed, national origin, sex, sexual orientation, age, disability, marital status, veteran's status, status with regard to public assistance, or any other protected status. Answers to application questions will be used for applicable, job-related reasons only.