Application for Employment "*" indicates required fields Step 1 of 7 14% Personal DataFirst Name* Middle Initial Last Name* Home PhoneCell Phone*Email* Social Security Number* Emergency Contact Are you at least 18 years of age?* Yes No Are you legally eligible for employment in the country?* Yes No Present Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code How long at present address?* Please list addresses for the last three years:Previous Address #1 Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Dates at Previous Address #1 (From - To) Previous Address #2 Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Dates at Previous Address #2 (From - To) You may click Next to continue to the next section. Driving Qualification/Accident RecordDo you have reliable transportation to and from work?* Yes No Do you have a valid driver’s license?* Yes No Driver's License # State Expiration Date Do you have a Commercial Driver’s License?* Yes No Type of Commercial Driver's License Have you ever been denied a license, permit or privilege to operate a motor vehicle?* Yes No Has any license, permit or privilege ever been suspended or revoked?* Yes No If the answer is yes to either of the two previous questions, please explainWhat traffic convictions and for forfeitures do you have over the past three years (other than parking violations)? Please list location, date, charge and penalty.What accidents have you been involved in the past three years or more? Please list date, nature of accident (head on, rear end, upset, etc), whether there were any fatalities, and whether or not there were any injuries.Driving ExperiencePlease include any relevant driving experience below.1. Class of Equipment: Straight TruckType of Equipment (Van, Tank, Flat) Dates (From – To) Approx # of Miles (Total) 2. Class of Equipment: Tractor and Semi TrailerType of Equipment (Van, Tank, Flat) Dates (From – To) Approx # of Miles (Total) 3. Class of Equipment: OtherType of Equipment (Van, Tank, Flat) Dates (From – To) Approx # of Miles (Total) You may click Next to continue to the next section. Application/Employment StatusList any prior dates of employment and positions with Lawrence Landscape List position and/or type of work for which you are applying* If referred to Lawrence Landscape for employment, who provided the recommendation? Type of employment desired:* Full Time Part Time Seasonal Temporary Date available for work* What is your desired salary range or rate of pay?* Are you available to work overtime, if necessary?* Yes No You may click Next to continue to the next section. Education HistoryHigh SchoolName of High School Location Years Completed Did you graduate? Yes No CollegeName of College/University Location Years Completed Major & Degree Did you graduate? Yes No Graduate SchoolName of Graduate School Location Years Completed Major & Degree Did you graduate? Yes No Technical CollegeName of Technical College Location Years Completed Major & Degree Did you graduate? Yes No You may click Next to continue to the next section. Personal ReferencesPlease enter up to three personal references below.Personal Reference #1Name Address PhoneYears Known May we contact the above individual for a reference? Yes No If no, why? Personal Reference #2Name Address PhoneYears Known May we contact the above individual for a reference? Yes No If no, why? Personal Reference #3Name Address PhoneYears Known May we contact the above individual for a reference? Yes No If no, why? Military Service RecordHave you ever been in the armed forces?* Yes No Date Entered Discharge Date If discharged, list date and type Special training and skills Criminal RecordHave you been convicted of a crime?* Yes No List date and nature of offense Name and location of court Disposition of case Name of probation/parole officer Phone number of probation officerMay we contact probation officer? Yes No Are there any felony misdemeanor charges pending against you? Yes No Description of felony misdemeanor charges You may click Next to continue to the next section. Skills and QualificationsResumeMax. file size: 50 MB.Please click on the Browse button to upload your resume.Describe what skills and qualifications you would bring to Lawrence Landscape if you were hired. Please list any hand tools you have experience using.*Skill Levels The following functions may be essential requirements of this position. Please rate your ability to perform the following functions/tasks using a scale of 1 to 10. (1=cannot perform and 10=can easily perform)Use a shovel to dig trenches several hours per day*Please enter a number from 1 to 10.Bend and/or squat repeatedly*Please enter a number from 1 to 10.Occasionally lift up to 110 lbs. waist high*Please enter a number from 1 to 10.Maintain and care for tools & equipment*Please enter a number from 1 to 10.Lift up to 50 lbs. shoulder high*Please enter a number from 1 to 10.Work in adverse conditions (snow/heat/rain/dust)*Please enter a number from 1 to 10.Willingness to perform duties not generally associated with the position*Please enter a number from 1 to 10.Work well with other and resolve problems in a responsible manner (respect chain of command)*Please enter a number from 1 to 10.Perform duties requiring repeated extension of arms over head*Please enter a number from 1 to 10.Follow multiple instructions/order simultaneously*Please enter a number from 1 to 10.You may click Next to continue to the next section. Form Waiver and SignatureApplication Form Waiver: Please read carefully*In exchange for the consideration of my job application by Lawrence Landscape, Inc.(hereinafter called “the Company”), I agree that: Neither the acceptance of this application nor the subsequent entry into any type of employment relationship, either in the position applied for or any other position, and regardless of the contents of employee handbooks, personnel manuals, benefit plans, policy statements, and the like as they may exist from time to time, or other Company practices, shall serve to create an actual or implied contract of employment, or to confer any right to remain an employee of Lawrence Landscape, Inc., or otherwise to change in any respect the employment-at-will relationship between it and the undersigned, and that relationship cannot be altered except by a written instrument signed by the President /General Manager of the Company. Both the undersigned and Lawrence Landscape, Inc. may end the employment relationship at any time, without specified notice or reason. If employed, I understand that the Company may unilaterally change or revise their benefits, policies and procedures and such changes may include reduction in benefits. I authorize investigation of all statements contained in this application. I understand that the misrepresentation or omission of facts called for is cause for dismissal at any time without any previous notice. I hereby give the Company permission to contact schools, previous employers (unless otherwise indicated), references, and others, and hereby release the Company from any liability as a result of such contract. I also understand that (1) the Company has a drug and alcohol policy that provides for pre-employment testing as well as testing after employment; (2) consent to and compliance with such policy is a condition of my employment; and (3) continued employment is based on the successful passing of testing under such policy. I further understand that continued employment may be based on the successful passing of job-related physical examinations. I understand that, in connection with the routine processing of your employment application, the Company may request from a consumer reporting agency an investigative consumer report including information as to my credit records, character, general reputation, personal characteristics, and mode of living. Upon written request from me, the Company, will provide me with additional information concerning the nature and scope of any such report requested by it, as required by the Fair Credit Reporting Act. Information regarding the Fair Credit Reporting Act can be found on the Federal Trade Commission’s website (www.ftc.gov). I further understand that my employment with the Company shall be probationary for a period of sixty (60) days, and further that at any time during the probationary period or thereafter, my employment relation with the Company is terminable at will for any reason by either party. I have read and agree to the Application Form Waiver. *Equal Employment Opportunity This Company is an equal employment opportunity employer. We adhere to a policy of making employment decisions without regard to race, color, religion, sex, sexual orientation, national origin, citizenship, age or disability. We assure you that your opportunity for employment with this Company depends solely on your qualifications.Signature of Applicant* Please type your name in the box above.CAPTCHAPhoneThis field is for validation purposes and should be left unchanged.
