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APPLICATION FOR EMPLOYMENT

All Candidates must be at least 18 years of age and have a valid Georgia driver’s license.
EQUAL OPPORTUNITY EMPLOYER    [Haga clic aquí para españoles]
E-Verify® is a registered trademark of
the U.S. Department of Homeland Security

* Required field

Personal Information
NAME (LAST NAME, FIRST):
*
SOCIAL SECURITY NO:
*
PRESENT ADDRESS, CITY, STATE, ZIP CODE:
* * * *
PERMANENT ADDRESS, CITY, STATE, ZIP CODE (If different):
PHONE NO: * REFERRED BY:
Employment Desired
POSITION: *    Landscape and Maintenance Laborers    Irrigation Technician
DATE YOU CAN START: * SALARY DESIRED:
ARE YOU EMPLOYED NOW? * Yes   No
ARE YOU LEGALLY AUTHORIZED TO WORK IN THE U.S.A.? * Yes   No
EVER APPLIED TO THIS COMPANY BEFORE? *  Yes   No
WHERE? WHEN?
Education
HIGH SCHOOL
NAME
*
LOCATION OF SCHOOL
*
YEARS ATTENDED * DID YOU GRADUATE? *   Yes   No
AFTER SCHOOL ACTIVITIES
COLLEGE
NAME
LOCATION OF SCHOOL
YEARS ATTENDED DID YOU GRADUATE?  Yes   No
SUBJECTS STUDIED
TRADE, BUSINESS OR CORRESPONDENCE SCHOOL
NAME
LOCATION OF SCHOOL
YEARS ATTENDED DID YOU GRADUATE?   Yes   No
SUBJECTS STUDIED
GENERAL INFORMATION
SUBJEGS OF SPECIAL STUDY OR RESEARCH WORK
SPECIAL TRAINING
SPECIAL SKILLS
U.S. MILITARY SERVICE
RANK
FORMER EMPLOYERS / EMPLEADORES ANTERIORES - BEGIN WITH MOST RECENT EMPLOYER / EMPIECE POR EL MAs RECIENTE
DATE, MONTH AND YEAR
NAME & ADDRESS OF EMPLOYER
SALARY
POSITION
REASON FOR LEAVING
FROM:
TO:
FROM:
TO:
FROM:
TO:
FROM:
TO:
REFERENCES
GIVE BELOW THE NAMES OF THREE PERSONS NOT RELATED TO YOU, WHOM YOU HAVE KNOWN AT LEAST ONE YEAR.
NAME PHONE BUSINESS YEARS KNOWN
* *
* *
* *
HAVE YOU EVER BEEN CONVICTED OF, PLEAD GUILTY INa CONTEST TO A CRIME? * Yea   No  
IF YES, EXPLAIN.

(A CONVICTION RECORD WILL NOT NECESSARILY EXCLUDE YOU FROM CONSIDERATION. THIS INFORMATION WILL BE USED ONLY FOR JO-B-RELATED PURPOSES AND ONLY TO THE EXTENT PERMITTED BY LAW.)
AUTHORIZATION
"I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for dismissal.
I authorize investigation of all statements contained herein and the references and employers listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release the company from all liability for any damage that may result from utilization of such information.
I also understand and agree that no representative of the company has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing, unless it is in writing and signed by an authorized company representative.
This waiver does not permit the release or use of disability-related or medical information in a manner prohibited by the Americans with Disabilities Act (ADA) and other relevant federal and state laws."
If you have read above authorization, please type your name and today's date here.

YOUR NAME *    DATE *



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