Employment

Date *

Address *

City *

State *

ZIP Code *

Home Phone

Cell Phone *

Is it a smartphone? *—Please choose an option—YesNo

Date Available *

Social Security No.

Desired Hourly Rate ($) *

Position Applied For *

If hired, do you have reliable transportation to and from work? *—Please choose an option—YesNo

High School

From

To

Did you graduate?—Please choose an option—YesNo

College

From

To

Did you graduate?—Please choose an option—YesNo

Degree

Other

From

To

Did you graduate?—Please choose an option—YesNo

Degree

Full Name *

Relationship *

Company

Phone *

Address

Full Name *

Relationship *

Company

Phone *

Address

Full Name *

Relationship *

Company

Phone *

Address

Phone

Supervisor

Job Title

Starting Wage ($)

Ending Wage ($)

Responsibilities

Start Date

End Date

Reason for Leaving

May we contact your previous supervisor for a reference?—Please choose an option—YesNo

Phone

Supervisor

Job Title

Starting Wage ($)

Ending Wage ($)

Responsibilities

Start Date

End Date

Reason for Leaving

May we contact your previous supervisor for a reference?—Please choose an option—YesNo

Phone

Supervisor

Job Title

Starting Wage ($)

Ending Wage ($)

Responsibilities

Start Date

End Date

Reason for Leaving

May we contact your previous supervisor for a reference?—Please choose an option—YesNo

Are you presently under a doctor's care? *—Please choose an option—YesNo

If yes, please explain

Have you ever been convicted of a crime? *—Please choose an option—YesNo

If yes, please explain when, where, and the nature of all criminal convictions

Are there any felony charges pending against you now? *—Please choose an option—YesNo

If yes, please describe

Driver's License Number *

Tickets in the last 5 years *

Points against license *

Why do you believe we should hire you for this position? *

Have you ever been compensated for a work-related injury? *—Please choose an option—YesNo

If yes, please explain

Vigh Landscape Management usually works 6 days a week in the spring and fall. Generally, in the summer we only work 5 days a week. Please explain any limitations you might have with these hours. *

What level of involvement are you looking for? *24/7 availability whenever it snowsPartial availability, where we work around your other work schedule, etc.Back-up reserve list to call and request help if we get a big storm, or need extra help

What is your availability? *

Is there anything else you want to tell us about yourself?

I have read and agree to the statements above.

Date *