Job Application Form

Full Name*

First NameLast Name

Email Address*

example@example.com

Phone Number*

Please enter a valid phone number.Format: (000) 000-0000.

Current Address*

Street Address

Street Address Line 2

CityState / ProvincePostal / Zip CodeCountry

Position Applied For*

Highest Level of Education Completed*

Name of School/Institution*

Field of Study/Major*

Year Graduated (or Expected)*

Do you have previous work experience?*

YesNo

Most Recent Employer:*

Job Title*

Employment Dates (From - To)*

Brief Description of Responsibilities*

Employer:*

Job Title*

Employment Dates (From - To)*

Brief Description of Responsibilities*

Employer:*

Job Title*

Employment Dates (From - To)*

Brief Description of Responsibilities*

Reference Name*

Reference Phone Number*

Please enter a valid phone number.Format: (000) 000-0000.

Reference Relationship*

Reference Email Address

example@example.com

Reference Name*

Reference Phone Number*

Please enter a valid phone number.Format: (000) 000-0000.

Reference Relationship*

Reference Email Address

example@example.com

Are you eligible to work in the United States?*

YesNo

Are you 18 years of age or older?*

YesNo

Do you have any state or felony convictions? If YES, describe below*

YesNo

If YES, describe here:*

Have you ever been employed by Green With Envy?*

YesNo

If YES, dates of employment & reason for leaving:*

Are you related to any current Green With Envy employees?*

YesNo

If YES, their name & relation to you:*

Do you have a valid PA driver's license?*

YesNo

If YES, license # and expiration date:*

Resume Upload (PDF, DOC, DOCX)

Additional information & comments:

PLEASE READ CAREFULLY AND SIGN THAT YOU UNDERSTAND AND ACCEPT THIS INFORMATION. I certify that the information on this application and its supporting documents is accurate and complete. I understand and agree that failure to fully complete the form, or misrepresentation or omission of facts, represents grounds for elimination from consideration for employment, or termination after employment if discovered at a later date. I authorize Green With Envy to investigate, without liability, all statements contained in this application and supporting materials. I authorize references and former employers, without liability, to make full response to any inquiries in connection with this application for employment. If requested, I agree to submit to a physical exam, criminal and credit background investigation, and/or screening for illegal substances upon conditional offer of employment. I understand that this document is NOT an offer of employment, and that an offer of employment, if tendered, does NOT constitute a contract for continued guaranteed employment. I understand that staff employees of Green With Envy serve at-will, and the employment relationship may be terminated at any time by either party, or any or no reason, other than a reason prohibited by law. If employed, I will be required to furnish proof of eligibility to work in the United States, to file a State security questionnaire and State loyalty oath, and to comply with company and departmental regulations. I understand that if employed on a temporary basis, I would be paid for hours worked only, and would be ineligible for benefits including paid time off. If employed on a regular, benefits-eligible basis, I understand that I would be required to make mandatory contributions to the Green With Envy Retirement System or to an optional retirement program, if applicable. I understand that any benefits I receive may be subject to change or discontinuation at any time without prior notice. I understand that the first NINE MONTHS of regular employment represent a provisional period, during which I would not be eligible to apply for transfer or promotion and during which I may be terminated without right of appeal.

Signature

Job Application Form

Personal Information

Education Background

Work Experience

Reference Information