An Equal Opportunity Employer
M B Landscaping, LLC is an equal opportunity employer. This application will not be used for limiting or excluding any applicant from consideration for employment on a basis prohibited by local, state, or federal law. Applicants requiring reasonable accommodation in the application and/or interview process should notify a representative of the organization.
Applicant Name
*
First Name
Last Name
Primary Phone Number
*
Please enter a valid phone number.
Alternate Phone Number
Please enter a valid phone number.
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
How were you referred to this company?
Position(s) applying for
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Temporary work-such as summer or holiday
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Y
N
Regular part-time work
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Y
N
Regular full-time work
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Y
N
What days and hours are you available for work?
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If hired, on what date can you start?
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Month
-
Day
Year
Date
Can you work weekends?
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Y
N
Can you work evenings?
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Y
N
Can you work overtime?
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Y
N
Salary Desired
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Have you ever applied to/worked for this company before?
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Y
N
If yes, please provide explanation and dates
Do you have any friends, relatives, or acquaintances working for this company?
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Y
N
If yes, state name and relationship
If hired, would you be willing to submit to a background check?
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Y
N
If hired, would you have transportation to/from work?
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Y
N
Do you have a CURRENT AND VALID Driver License?
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Y
N
Driver License Number
State that Issued License
Expiration Date of License
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Month
-
Day
Year
Date
Are you over the age of 18? (If under 18, hire is subject to verification of minimum legal age)
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Y
N
If hired, would you be able to present evidence of your U.S. citizenship or proof of your legal right to work in the United States?
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Y
N
If hired, are you willing to submit to and pass a controlled substance test?
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Y
N
Are you able to perform the essential functions of the job for which you are applying, either with/without reasonable accommodation?
*
Y
N
If no, describe the functions that cannot be performed
Note:
Company complies with the ADA and considers reasonable accommodation measures that may be necessary for eligible applicants/employees to perform essential functions. It is possible that a hire may be tested on skill/agility and may be subject to a medical examination conducted by a medical professional
High School
Name of High School
Address of High School
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Number of years completed
Did you graduate?
Y
N
Degree/Diploma Earned
College/University
Name of College/University
Address of College/University
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Number of years completed
Did you graduate?
Y
N
Degree/Diploma Earned
Vocational School
Name of Vocational School
Address of Vocational School
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Number of years completed
Did you graduate?
Y
N
Degree/Diploma Earned
Do you speak, write or understand any foreign languages?
*
Y
N
If yes, describe which language(s) and how fluent of a speaker you consider yourself to be.
Do you have any other experience, training, qualifications, or skills which you feel should be brought to our attention, in the case that they make you especially suited for working with us?
*
Y
N
If yes, please explain
Are you currently employed?
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Y
N
If you are currently employed, may we contact your current employer?
*
Y
N
Below, please describe past and present employment positions, dating back five years. Please account for all periods of unemployment. EVEN IF YOU HAVE ATTACHED A RESUME, THIS SECTION MUST BE COMPLETED.
Name of Employer
*
Name of Supervisor
*
First Name
Last Name
Employer Phone Number
*
Please enter a valid phone number.
Business Type
*
Business Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Length of Employment (include dates)
*
Position and Duties
*
Reason for Leaving
*
May we contact this employer for references?
*
Y
N
Name of Employer
*
Name of Supervisor
*
First Name
Last Name
Employer Phone Number
*
Please enter a valid phone number.
Business Type
*
Business Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Length of Employment (include dates)
*
Position and Duties
*
Reason for Leaving
*
May we contact this employer for references?
*
Y
N
Name of Employer
*
Name of Supervisor
*
First Name
Last Name
Employer Phone Number
*
Please enter a valid phone number.
Business Type
*
Business Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Length of Employment (include dates)
*
Position and Duties
*
Reason for Leaving
*
May we contact this employer for references?
*
Y
N
Professional Reference - 1
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Address
Street Address
Address Line 2
City
State / Province
Postal / Zip Code
Occupation
*
Numbers of years Acquainted
*
Professional Reference - 2
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Occupation
*
Number of years Acquainted
*
Professional Reference - 3
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Occupation
*
Number of years acquainted
*
By signing below I certify that I have not purposely withheld any information that might adversely affect my chances for hiring. I attest to the fact that the answers given by me are true and correct to the best of my knowledge and ability. I understand that any omission (including misstatement) of material fact on this application or on any document used to secure employment can be grounds for rejections of application or, if I am employed by this company, terms for my immediate expulsion from the company. I understand that if I am employed, my employment is not definite and can be terminated at any time either with or without prior notice, and by either me or the company.
Signature
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Today's Date
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Month
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Day
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Date
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