Job Application - Midcoast Landscape & Masonry

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General Information

Name*

First Last

Date of Birth*

Email*

Phone*

Alternative Phone

Address*

Street Address Address Line 2 City State ZIP Code

Position Applied For

Salary Desired

Days Available to Work

No Preference

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

Employment Desired

Full-Time Only

Part-Time Only

Full or Part Time

Date Available to Start

Do You Smoke?

Yes

Are You a Citizen of the United States?

Yes

If not, are you authorized to work in the U.S.?

Yes

Education

High School

Did you graduate?

Yes

College

Did you graduate?

Yes

Business/Trade School

Did you graduate?

Yes

Driving Record

Do you have a valid drivers license?

Yes

Are you proficient at pulling a trailer?

Yes

Somewhat

What is your means of transportation to work?

Driver's Number

State of Issue

License Type

Operator

Commercial (CDL)

Expiration Date

Have you had any accidents in the past 3 years

Yes

How Many?

Have you had any moving violations in the past 3 years

Yes

How Many?

Landscape Experience

Describe landscaping experience (i.e. lawn installations, irrigation, maintenance, pruning, planting, retaining walls, etc.)

Describe equipment you are familiar with.

Work Experience

Please list your work experience for the past five years beginning with your most recent job held. If you were self-employed, give firm name.

Name of Employer

Name of Supervisor

Phone

Your Last Job Title

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Employed from

Starting Salary

Employed to

Final Salary

Reason for Leaving (be specific)

List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company.

Name of Employer

Name of Supervisor

Phone

Your Last Job Title

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Employed from

Starting Salary

Employed to

Final Salary

Reason for Leaving (be specific)

List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company.

Name of Employer

Name of Supervisor

Phone

Your Last Job Title

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Employed from

Starting Salary

Employed to

Final Salary

Reason for Leaving (be specific)

List the jobs you held, duties performed, skills used or learned, advancements or promotions while you worked at this company.

May we contact your present employer?

Yes

References

Name

First Last

Company

Position

Relationship

Phone

Name

First Last

Company

Position

Relationship

Phone

Name

First Last

Company

Position

Relationship

Phone

Please Read Carefully

In exchange for the consideration of my job application by Midcoast Landscape & Masonry (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 Midcoast Landscape & Masonry 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 owner of the Company. Both the undersigned and Gilliland Landscape 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 possible pre-employment testing as well as random and /or periodic 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 further understand that my employment with the Company shall be probationary for a period of thirty (30) 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.

This Company is an equal employment opportunity employer. We adhere to a policy of making employment decisions without regard to race, color, religion, sex, national origin, citizenship, age or disability. We assure you that your opportunity for employment with this Company depends solely on your qualifications.

Thank you for completing this application form and for your interest in our business.

Midcoast Landscape & Masonry

18 Farwell Drive (Rt. 90), Rockland, Maine 04841

Email: pbelcher6@yahoo.com

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