Executive Landscaping
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application for employment
executive landscaping, inc.

equal employment opportunity

Executive Landscaping, Inc. is an equal opportunity employer. this means that all applicants for all positions without regard to race, color, national origin, religion, age, sex, marital status, pregnancy, sexual orientation, the presence of non-job-related medical condition or disability, veteran status or any other legally protected class.

Today's Date
personal information

name:

present address:

permanent address (if different than present address):

phone number:

emergency contact information:

in case of an emergency notify:

Are you legally eligible for employment in the United States? (If Yes, verification will be required.) *

Are you under the age of 18? *

Are you requesting any accommodation to complete the application process? *

employment desired

job:

interest:

You must select at least one Interest *

were you referred by any of the following?

Are you currently employed? *

If yes, may we inquire of your present employer?

Have you ever applied to work for executive landscaping, inc. before? *

Were you hired?

general information
employment information

Are you physically and mentally able to perform the job applied for? *

If no, is there any accommodation that would allow you to perform this job? *

Can you work overtime? *

Can you work overtime without prior notice? *

Can you work on saturday? *

Can you work on sunday? *

Can you travel out of state if required by this position? *

Can you travel within a 60 mile radius of your home? *

Have you ever been convicted of a felony? *

NOTE: The applicant is not required to disclose the existence of any arrest, criminal charge or conviction, the records of which have been erased pursuant to connecticut general statutes sections 46b-146, 54-76o or 54-142a. the applicant is not required to disclose the existence of criminal records that are subject to erasure pursuant to connecticut general statutes sections 46b-146, 54-76o and 54-142a which are records pertaining to a finding of delinquency or that a child was a member of a family with service needs, an adjudication as a youthful offender, a criminal charge that has been dismissed or nolled, a criminal charge for which the person has been found not guilty or a conviction for which the person received an absolute pardon. the applicant is not required to disclose the existence of criminal records that have been erased pursuant to connecticut general statutes sections 46b-146, 54-76o or 54-142a since the applicant shall be deemed to have never been arrested within the meaning of the general statutes with respect to these proceedings so erased and may so swear under oath.

driver information

Many positions at executive landscaping, inc. require employees to drive. if you are applying for a driver's position or a position which requires driving, please answer the following:

Do you have a valid driver's license? *

If yes

Do you have a CDL? *

Has your license ever been revoked or suspended? *

educational history
elementary * high school * college * trade school * other *
school name
years completed
diploma/degree received?
subjects studied
employment history

List below your employers for the last ten (10) years. start with your most recent employer first. *

Date Month and Year Name and Address of Employer Salary Position Reason For Leaving






references

Give names of five persons not related to you, whom you have known for at least one year, who can provide a reference: *

Name City & State Telephone Number Occupation Years Known
office use only:

Driver:

if yes: need copy of license

driver's application completed
dot drug testing
dot medical card current

applicant's certifications and agreements

TO ALL APPLICANTS: PLEASE READ THIS SECTION CAREFULLY AND SIGNIFY YOUR UNDERSTANDING BY SIGNING YOUR NAME IN THE SPACE PROVIDED.

I certify that all of the statements made by me on this application for employment are true, correct, and complete to the best of my knowledge. I understand that any falsification or material omission of fact on this application shall lead to refusal of employment or dismissal from employment. I authorize any investigation into the statements I have made in this application as necessary to arrive at an employment decision. In consideration of my employment, I agree to conform to the rules, regulations and policies of Executive Landscaping, Inc. with the understanding that such rules, regulations and policies (including those pertaining to compensation and benefits) may be changed by Executive Landscaping, Inc. at any time during my employment.

I understand that the Executive Landscaping, Inc. follows an "EMPLOYMENT AT WILL" policy, in that Executive Landscaping, Inc. or I may terminate my employment at any time, with or without notice, for any reason consistent with applicable State or Federal law. I understand that all employment appointments are "introductory," during which "introductory period," I must demonstrate my fitness for continued employment. I further understand that successful completion of the introductory period does not guarantee continued employment. I also understand that No manager, supervisor or other individual at Executive Landscaping, Inc. has authority to make a commitment of guaranteed of continuing employment to me, and I understand that no document or publication of Executive Landscaping, Inc. should be interpreted to make such a guarantee. NOTHING STATED BY EXECUTIVE LANDSCAPING, INC., IN WRITING OR ORALLY, DURING THE INTERVIEW AND/OR HIRING PROCESS IS TO BE CONSTRUED AS CREATING A CONTRACT BETWEEN EXECUTIVE LANDSCAPING, INC. AND MYSELF.

I authorize representatives of Executive Landscaping, Inc. to obtain pertinent information from my previous employers, references, and other persons with knowledge of my work history and background. I authorize my previous employers, references, and persons with knowledge of my work history and background to provide pertinent information to Executive Landscaping, Inc. and hereby release all such persons and waive any and all claims, demand or causes of action whatsoever, in connection with the request for release of such information. I also voluntarily agree to submit to any lawful security examination or investigation as a condition precedent to employment or at any time during my employment. I hereby release Executive Landscaping, Inc., its subsidiaries and affiliated companies, its agents and employees from any liability resulting from or in connection with the results or use of the results of any of the above described examinations, reference checks and investigations.

I understand that, as part of the application process, Executive Landscaping, Inc. conducts thorough background checks (which may include a check of my criminal history) on prospective employees. I agree that, if contacted with respect to such background check, that I will fully cooperate and provide any information requested. understand that, as a condition of my consideration for employment with Executive Landscaping, Inc., or as a condition of my continued employment with Executive Landscaping, Inc., Executive Landscaping, Inc. may obtain a consumer report that includes, but is not limited to, my creditworthiness or similar characteristics, employment and education verifications, social security verification, criminal and civil history, personal interviews, DMV records, any other public records and any other information bearing on my credit standing, credit capacity, character, general reputation, personal characteristics and trustworthiness.

I hereby authorize and consent to Executive Landscaping, Inc.'s procurement of such a report. I understand that, pursuant to the federal Fair Credit Reporting Act, Executive Landscaping, Inc. will provide me with a copy of any such report if the information contained in such report is, in any way, to be used in making a decision regarding my fitness for employment with Executive Landscaping, Inc. I further understand that such report will be made available to me prior to any such decision being made, along with the name and address of the reporting agency that produced the report.

I understand that I am not required to disclose the existence of any arrest, criminal charge or conviction, the records of which have been erased pursuant to Connecticut General Statutes sections 46b-146, 54-76o or 54-142a. The applicant is not required to disclose the existence of criminal records that are subject to erasure pursuant to Connecticut General Statutes sections 46b-146, 54-76o and 54-142a which are records pertaining to a finding of delinquency or that a child was a member of a family with service needs, an adjudication as a youthful offender, a criminal charge that has been dismissed or nolled, a criminal charge for which the person has been found not guilty or a conviction for which the person received an absolute pardon, and The applicant is not required to disclose the existence of criminal records have been erased pursuant to Connecticut General Statutes sections 46b-146, 54-76o or 54-142a since the applicant shall be deemed to have never been arrested within the meaning of the general statutes with respect to these proceedings so erased and may so swear under oath.

As a condition of employment, I understand that information relative to the status of any driving duties, particularly insurability of an employee who drives as part of his/her job, is an important job function. In the event that I am called upon to drive as part of my job functions with Executive Landscaping, Inc. then as a condition of my employment, I hereby authorize my employer and its insurance agent to ask for and receive information relative to the status of my motor vehicle operator's license and motor vehicle history in every State in which I have held a motor vehicle operator's license. This authorization is valid from the date of my signature below throughout the term of my employment in which driving an Executive Landscaping, Inc. motor vehicle is an essential job function. I understand that if at any time (now or in the future) Executive Landscaping, Inc. cannot insure me due to my motor vehicle operator history, my employment may be terminated.

And finally, I voluntarily consent to a controlled substance test in accordance with applicable law and understand that a positive and properly confirmed drug test for controlled substances or refusal to submit to a drug test is grounds for denial or termination of employment. I also voluntarily consent to a medical examination conducted at the request of Executive Landscaping, Inc. I understand that the results of these medical examinations and tests will be provided to Executive Landscaping, Inc.

I have read, understand and agree to the forgoing.

name:

employment information authorization and release

, , hereby authorize my previous employers to release to Executive Landscaping, Inc., and discuss, any and all employment and personnel information requested, including, but not limited to personnel records, payroll records and any other documents of any nature in your possession, custody or control. I hereby specifically release and hold harmless Executive Landscaping, Inc. and any past, present and future employers, their employees and agents, from any and all claims or liability as a result of disclosing or revealing any record or information concerning my employment, in accordance with this authorization to Executive Landscaping, Inc.

name:

A photocopy of this authorization and release is as valid as the original.


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