Fawn Landscaping and Nursery, Inc.

APPLICATION FOR EMPLOYMENT

(PRE-EMPLOYMENT QUESTIONNAIRE) (AN EQUAL OPPORTUNITY EMPLOYER)

*ONCE FINISHED WITH FORM, PRINT OUT

Date:
Social SecurityNumber:

 

 

Last Name: First Name: Middle:    
Present Address:
 Street: City: State: Zip:
Permanent Address: Street: City: State: Zip:
Phone Number: Are you 18 Years or older?

Yes
No


 
Are you prevented from lawfully becoming employed in this country because of visa or immigration status? Yes
No
   

Employment Desired:

    
Position: Date you can start: Salary Desired:
Are you employed now? If so,may we inquire of your present employer? Yes
No

 
Ever applied to this company before? Where? When?  

Education:
Name & Location of School
*No. of Years Attended
*Did you Graduate?
Subjects Studied
Grammar School
High School
College
Trade, Business, or Correspondence School

General:

        
Subjects of Special Study or Research Work:
Special Skills:
Activities: (Civic, Athletic, etc.)
Exclude organizations. The name of which indicates the race, creed, sex, age, martial status, color or nation of origin of its members.        
U.S. Military or Naval Service: Rank:
Present Membership in National Guard or Reserves:    

Former Employers:

 (List below last three employers, starting with last one first)
 
Date, Month, and Year
Name and Address of Employer
Salary
Position
Reason for Leaving
From:
To:
Name:
Address:
From:
To:
Name:
Address:
From:
To:
Name:
Address:
Which of these jobs did you like best?      
What do you like most about this job?      

References:

 Give the Names of Three Persons not related to you, whom you have known at least one year.
Name
Address
Business
Years Acquanted
1

Line 1:
Line 2:

2
Line 1:
Line 2:
3
Line 1:
Line 2:


The following statement applies in: Maryland & Massachusetts.
It is unlawful in the state of to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liablity.

In Case of Emergency Notify: Name: Address: Phone No.:

"I certify that all the information submitted by me on this application is true and complete, and I understand that if any false information, omissions, or misrepresentations are discovered, my application may be rejected and, if I am employed, my employment may be terminated at any time.
In consideration of my employment, I agree to conform to the company's rules and regulations, and I agree that my employment and compensation can be terminated, with or without cause, and with or without notice. At any time, at either my or the company's option. I also understand and agree that the terms and conditions of my employment may be changed, with or without cause, and with or without notice, at any time by the company. I understand that no company representative, other than it's president, and then only when in writing and signed by the president, has any authority to enter into any agreement for employment for any specific period of time, or to make any agreement contrary to the foregoing."

*ONCE FINISHED WITH FORM, PRINT OUT

* This form has been revised to comply with the provisions of the Americans with Disabilities Act and the final regulations and interpretive guidance promulgated by the EEOC on July 26, 1991.