Empire Snow Removal | Job Application

Empire Landscaping and Snow Plowing, Inc.

Employment Application
Current Date

MonthDayYearHourMinutesAM/PM Option
Full Name*

First NameLast NameSuffix
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number*

Area CodePhone Number
Social Security Number
Birth Date*

MonthDayYear
E-mail
Have you ever been convicted of a crime?*

YesNo
If "Yes", please explain:
License Classification
Do you hold a CDL License?*

YesNo
State of Issue
Check all that apply:

Class AClass BClass CClass DTank EndorsementHazMatNone
Position Applying for (Heavy Equipment Operation):

Equipment OperatorPlow TruckSalt TruckLiquid Anti-Icer
Position Applying for (Sidewalk Crew):

MachineATV w/PlowSnow BlowerShoveler
Desired Pay Rate*
Previous Experience with Equipment
Check all that apply:

Front End Loader: 1-2.5 yardsFront End Loader: 2.5 and up (yards)Back HoeSkid SteerVersa LoaderPlow TruckLiquid Anti-Icing TruckSalt TruckATV w/PlowSnow BlowerShovelSalt Spreaders
Previous Experience in Snow Removal
Years Experience in snow removal:*
Rate your experience in snow removal. 1 being the least and 5 being the most.*
Previous Experience in Mechanics
Years Experience in mechanics:*
Rate your experience in mechanics. 1 being the least and 5 being the most.*
Previous Experience in Welding
Years Experience in welding:*
Rate your experience in welding. 1 being the least and 5 being the most.*
Previous Experience in Electrical
Years Experience in electrical:*
Rate your experience in electrical. 1 being the least and 5 being the most.*
Job History
Previous snow removal company worked for:
Name of last supervisor:
Dates of employment:
Salary:
Last job title:
Reason for leaving (be specific):
Job History (2)
Name of employer:
Name of last supervisor:
Dates of employment:
Salary:
Last job title:
Reason for leaving (be specific):
Do you have transportation to the job site?*

YesNo
Do you have the following? Check all that apply

Cell PhoneSmart Phone (internet, applications, etc.)Internet Access (computer)Text Messaging (SMS) Plan
Is transportation 4-Wheel Drive?*

YesNo
When are you available?*

Weather event onlyDayNightDay AND Night
Snow season begins November 1st. How soon can you begin?*
Should be Empty:

Empire Landscaping and Snow Plowing, Inc.

License Classification

Previous Experience with Equipment

Previous Experience in Snow Removal

Previous Experience in Mechanics

Previous Experience in Welding

Previous Experience in Electrical

Job History

Job History (2)