Empire Snow Removal | Job Application

Empire Landscaping and Snow Plowing, Inc.

Employment Application
Current Date

Month Day Year Hour Minutes AM/PM Option
Full Name *

First Name Last Name Suffix
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Phone Number *

Area Code Phone Number
Social Security Number
Birth Date *

Month Day Year
E-mail
Have you ever been convicted of a crime? *

Yes No
If "Yes", please explain:
License Classification
Do you hold a CDL License? *

Yes No
State of Issue
Check all that apply:

Class A Class B Class C Class D Tank Endorsement HazMat None
Position Applying for (Heavy Equipment Operation):

Equipment Operator Plow Truck Salt Truck Liquid Anti-Icer
Position Applying for (Sidewalk Crew):

Machine ATV w/Plow Snow Blower Shoveler
Desired Pay Rate *
Previous Experience with Equipment
Check all that apply:

Front End Loader: 1-2.5 yards Front End Loader: 2.5 and up (yards) Back Hoe Skid Steer Versa Loader Plow Truck Liquid Anti-Icing Truck Salt Truck ATV w/Plow Snow Blower Shovel Salt 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? *

Yes No
Do you have the following? Check all that apply

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

Yes No
When are you available? *

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

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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)