Employment Application

APPLICATION FOR EMPLOYMENT AT ROLLING GREENS

The Company does not discriminate on the basis of sex, age, color, race, religion, marital status, national origin, ancestry, sexual orientation, physical & mental disability, medical condition, genetic information, veteran status, or any other basis protected by federal, state or local law.
Locations (check boxes where you would like to apply)
Full Name

First NameLast Name
Date of Application
MM/DD/YYYY
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email
example@example.com
Phone/Cell

Area CodePhone Number
If hired, can you submit verification of your legal right to work in the U.S.?
Are you 18 years of age or older?
List any friends or relatives at the company:
Have you been previously employed here?
If yes, list date(s):
Positions Desired
Desired Employment
Please specify hours and days available:
Desired Salary
Available Start Date
MM/DD/YYYY
MILITARY SERVICE RECORD
Have you had any experience in the Armed Forces of the United States or in a state National Guard?
If yes, what branch?
Rank at discharge:
Date of discharge:
MM/DD/YYYY
Are you in the Reserves?
If yes, date obligation ends:
MM/DD/YYYY
Special technical training:
EDUCATION
High School Education
Name, Location, Years completed, Diploma or Degree, Courses of study
College Education
Name, Location, Years completed, Diploma or Degree, Courses of study
Graduate Education
Name, Location, Years completed, Diploma or Degree, Courses of study
Vocation/Training
Name, Location, Years completed, Diploma or Degree, Courses of study
Any other education
Name, Location, Years completed, Diploma or Degree, Courses of study
EMPLOYMENT EXPERIENCE
Employer 1
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number

Area CodePhone Number
Job Title
Supervisor
Start + End Dates
Work Performed
Reason for leaving
Employer 2
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number

Area CodePhone Number
Job Title
Supervisor
Start + End Dates
Work Performed
Reason for leaving
Employer 3
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number

Area CodePhone Number
Job Title
Supervisor
Start + End Dates
Work Performed
Reason for leaving
Reference 1
Name + Title
Email
example@example.com
Phone Number

Area CodePhone Number
Number of years worked with
Reference 2
Name + Title
Email
example@example.com
Phone Number

Area CodePhone Number
Number of years worked with
Reference 3
Name + Title
Email
example@example.com
Phone Number

Area CodePhone Number
Number of years worked with
ADDITIONAL INFORMATION
Anything else you would like us to know about you?
AUTHORIZATION AND UNDERSTANDING

Please read carefully before signing
AT-WILL EMPLOYMENT STATUS: I agree that either party may terminate the employment relationship, with or without cause, at any time, for any reason, and further agree that this arrangement may only be changed by the COO, in writing, directed to me personally, and signed by the COO. I agree to be bound by the rules, policies, regulations, and terms and conditions of employment of the company, which are subject to change at any time. I further agree that my employment is conditional upon satisfactory completion of documentation as required by the Immigration Reform Control Act of 1986.
RELEASE OF PRIOR RECORDS: I give the company my permission to verify the information provided on this application including, but not limited to, my prior employment, education, or military service through the appropriate individuals, companies, organizations, and/or governmental agencies.
DRUG-FREE EMPLOYMENT: I understand that the company maintains a policy of drug-free employment. All offers of employment will be conditioned upon successful passing of a drug and/or alcohol test. *Please note a pre-employment physical to obtain a physician’s clearance may be required for some positions.
ACKNOWLEDGEMENT OF FULL DISCLOSURE: I acknowledge that all of the information provided by me now or later provided by me in support of my application for employment is true and complete. I understand that my employment may be terminated should the company determine that the information provided by me is not true and correct, regardless of when it is discovered by thecompany.
ACCOMMODATIONS: I understand that if I have a protected disability that affects my ability to perform the job I seek, I may ask the company to attempt to make a reasonable accommodation for it. I must make my request in writing to the Human Resources Director.
CONFIDENTIALITY AND NON-DISCLOSURE: During and after my employment with the company, I agree not to, directly or indirectly, disclose, use, publish, or make available for any unauthorized purpose, any confidential or proprietary information regarding the company or its business, including trade secrets. I further agree not to directly or indirectly attempt to reconstruct or otherwise recreate any confidential information of the company. I further acknowledge and agree to treat, hold, and maintain all confidential information as strictly confidential and I will use my best efforts and utmost diligence to guard and protect the confidential information fromany unauthorized disclosure to a third-party individual or entity.
Signature
Full Name
Date
MM/DD/YYYY
Should be Empty:

APPLICATION FOR EMPLOYMENT AT ROLLING GREENS

AUTHORIZATION AND UNDERSTANDING