Primrose Employment Application Form

Looking for qualified applicants.

Fill out the information below and click submit.
Name:*

First NameLast Name
Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number:*

Area CodePhone Number
Date of Birth:
E-mail Address:*
Position Applying for:
Date Available:
Desired Salary:
Are you a citizen of the United States?

YesNo
Are you authorized to work in the U.S.?

YesNo
Have you ever worked at Primrose Landscaping?

YesNo
If so, when?
If yes, explain:

Skills

List all previous experience.
Landscaping, Hardscaping, Heavy Equipment, Mechanical, Layout, etc.
Other
Can you perform the functions of the job without special accommodation?

YesNoOther

Background Information

Each case is considered separately based on job duties and performance areas.
Do you hold a valid Pennsylvania Driver's License?

YesNoOther
If primary position applied for involves driving, have you been convicted, plead no contention, or paid a fine for any traffic violation in the past three (3) years?

YesNo
If yes, explain:
Have you been convicted of a felony or served time in prison/jail within the last ten (10) years? (conviction will not necessarily bar you from employment)

YesNo
If yes, explain:
Do you hold a valid Commercial Driver's License?

YesNo
Endorsements:

Professional References

Please list two (2) references who can evaluate your work performance.
Reference 1
Name:*

First NameLast Name
Phone Number*

Area CodePhone Number
Years Known:*
Relationship:
Reference 2
Name:*

First NameLast Name
Phone Number*

Area CodePhone Number
Years Known:*
Relationship:
Should be Empty:

Looking for qualified applicants.