Job Application Form - Nicholls Landscaping

Employment Application

Our policy is to provide equal employment opportunity to all qualified persons without regard to race, creed, color, religious belief, sex, age, national origin, ancestry, physical or mental disability, or veteran status.

Step 1 of 6 - Contact Information

Name*
First Name Middle Name Last Name
Address*
Street Address Address Line 2 City State ZIP Code
Date of Birth*
Telephone*
Social Security #

Position applied for
How did you hear of this opening?
When can you start?*
Desired Wage $

U.S. Citizen*
Are you a U.S. citizen or otherwise authorized to work in the U.S. on an unrestricted basis? (You may be required to provide documentation.)
- Yes
- No
Do you have a valid driver’s license?*
- Yes
- No
Are you looking for full-time employment?*
- Yes
- No
If no, what hours are you available?
Have you ever been convicted of a felony?*
- Yes
- No
This will not necessarily affect your application
If yes, please describe the felony conditions

High School
Year, Major & Degree
College
Year, Major & Degree
College
Year, Major & Degree
Post College
Year, Major & Degree
Other Training
Year, Major & Degree
In addition to your work history, are there other skills, qualifications, or experience that we should consider?

Company Name*
Company Address*
Company Phone*
Name of Supervisor*
Supervisor Phone*
Date Started*
Starting Wage*
Starting Position*
Date Ended*
Ending Wage*
Ending Position*
Responsibilities*
Reason for leaving*
Company Name
Company Address
Company Phone
Name of Supervisor
Supervisor Phone
Date Started
Starting Wage
Starting Position
Date Ended
Ending Wage
Ending Position
Responsibilities
Reason for leaving
Company Name
Company Address
Company Phone
Name of Supervisor
Supervisor Phone
Date Started
Starting Wage
Starting Position
Date Ended
Ending Wage
Ending Position
Responsibilities
Reason for leaving
Company Name
Company Address
Company Phone
Name of Supervisor
Supervisor Phone
Phone Number
Date Started
Starting Wage
Starting Position
Date Ended
Ending Wage
Ending Position
Responsibilities
Reason for leaving

I certify that the facts set forth in this application for employment are true and complete to the best of my knowledge. I understand that if I am employed, false statements on this application shall be considered sufficient cause for dismissal. This company is hereby authorized to make any investigations of my prior educational and employment history.

I understand that employment at this company is “at will,” which means that either I or this company can terminate the employment relationship at any time, with or without prior notice, and for any reason not prohibited by statute. All employment is continued on that basis. I understand that no supervisor, manager, or executive of this company, other than the president, has any authority to alter the foregoing.
Full Name*
Date*