Employment Application Form

(Please Print)

 

Date                                                                                                                                                   

 

Personal

 

Name                                                                           Telephone                                                     

 

Address                                                                        Social Security #                                           

 

City, State, ZIP                                                                                                                                  

 

Are you 18 years of age or older?                  Yes                               No                                         

 

Do you have a valid drivers license?              Yes                               No                                         

 

License #                                                         State                            Expiration Date                     

 

Have you ever been convicted of a felony?  Yes                               No                                                          

If yes, please explain                                                                                                                         

 

Education

 

 

Name of School

Number of Years

Completed

Graduated?

Yes/No

Course or Major

 

High School

 

 

 

 

 

 

College

 

 

 

 

 

 

Vocational or Technical

 

 

 

 

 

 

Employment History

 

Company                                                                                                                                             

 

Address                                                                         City                                                                

 

State                               ZIP                                         Phone Number                                                

 

Your Supervisor’s Name                                                                                                                       

 

Employed from:                                    to:                    Your Title                                                           

 

Your Duties                                                                                                                                          

 

Your Salary/Wages                                                                                                                                        

 

Reason for Leaving                                                                                                                                

 

 

Company                                                                                                                                             

 

Address                                                                         City                                                                

 

State                               ZIP                                         Phone Number                                                

 

Your Supervisor’s Name                                                                                                                       

 

Employed from:                                    to:                    Your Title                                                           

 

Your Duties                                                                                                                                          

 

Your Salary/Wages                                                                                                                                        

 

Reason for Leaving                                                                                                                              

 

 

Company                                                                                                                                             

 

Address                                                                         City                                                                

 

State                               ZIP                                         Phone Number                                                

 

Your Supervisor’s Name                                                                                                                       

 

Employed from:                                    to:                    Your Title                                                           

 

Your Duties                                                                                                                                          

 

Your Salary/Wages                                                                                                                                        

 

Reason for Leaving                                                                                                                              

 

 

List machines and equipment, which you are able to operate                                                          

 

                                                                                                                                                           

 

Add anything you wish that might help us evaluate you application                                     

 

                                                                                                                                                           

 

 

The answers I have given are true to the best of my knowledge.  I authorize this company to investigate the statements I have made.  I understand that this company is an “Employment At Will” employer and that I may terminate my employment at any time for any reason and that the company may also terminate my employment at any time for any reason.

 

 

Signature                                                                                              Date                                      

 

 

Our company is an equal opportunity employer.  Applications and employment decisions are made without regard to race, color, religion, sex, national origin, marital status, veteran status, or any other legally protected status.

 

 

Mail to: Ultimate Lawn and Landscape, 701 Downs Avenue, Lexington, KY 40509 -- (859) 543-0025