Application For Employment

Date:______________________ Position(s) Applied For:____________________________________

____Full Time            ____Part Time            ___Full or Part Time

If you are applying for Part Time, what days and hours are you available? _________________________

_________________________________________________________________________________

Your Name:________________________________Telephone Number__________________

Current Address__________________________City___________________Zip________

How did you learn about us?

___Advertisement         ___Friend         ___Walk-in         ___Employment Agency         ___Relative

References - List the Name, Address, and Telephone Number of three (3) references who are not relatives or former employees.

____________________________________________________________________________
Name                                                  Address                                              Phone #

____________________________________________________________________________
Name                                                  Address                                              Phone #

____________________________________________________________________________
Name                                                  Address                                              Phone #

Please list the extent of your Education, including trade schools, apprenticeship programs and military experience.

____________________________________________________________________________________________

____________________________________________________________________________________________

____________________________________________________________________________________________

Briefly explain why you want to work for our company, and what your goals are for the future.

____________________________________________________________________________________________

____________________________________________________________________________________________

____________________________________________________________________________________________

Please Answer The Following Questions With As Much Detail As Necessary:

1.         Are you prevented from lawfully becoming employed in this country because of Visa or Immigration
            Status?    ________No  ______Yes  

2.         Have you been convicted of a felony, or are there any convictions pending?

            ______No  _____Yes-if Yes give details ___________________________________________

            ___________________________________________________________________________

3.         Are you currently employed?             ______No  _____Yes

4.         If you are currently employed, may we contact your employer for references?  _____No  _____Yes

5.         On what date are you available to start work? __________________________

6.         Can you travel to jobsites within 60 miles of Milwaukee?  _____No  _____Yes

7.         Do you have objections to working Saturdays or Sundays if necessary?  _____No  _____Yes

8.         Do you have a valid Wisconsin Driver’s License?  _____No  _____Yes. If Yes please fill in the following 

            information:   D L #________________________Expiration Date:_________Date of Birth_________.

9.         Do you have a CDL (Commercial Driver’s License) _____No  _____Yes  If Yes, what classifications are 

you approved for?____________________________________________________

Have you driven a truck before? _____No  _____Yes.     What size was the truck?  ____________.  

If Yes did it have a manual transmission?  _____No  _____Yes. 

Employment History - List the three employers you had beginning with the most recent:

Employer:______________________________ Address:__________________________________

Telephone Number:____________________ Your Position: _________________Salary:_________

Supervisor: ___________________________Start Date: ___________ Finish Date: ____________

Reason You Left:__________________________________________________________________

Employer:______________________________ Address:__________________________________

Telephone Number:____________________ Your Position: _________________Salary:_________

Supervisor: ___________________________Start Date: ___________ Finish Date: ____________

Reason You Left:__________________________________________________________________

Employer:______________________________ Address:__________________________________

Telephone Number:____________________ Your Position: _________________Salary:_________

Supervisor: ___________________________Start Date: ___________ Finish Date: ____________

Reason You Left:__________________________________________________________________

I certify that the facts contained in this application are true and complete to the best of my knowledge and I understand that if employed false statements shall be grounds for dismissal. I authorize investigation of all statements contained and the references 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 all parties from all liability for any damage that may result from furnishing same to you. I understand and agree that if hired my employment is for no definite period and may regardless of the date of payment of my wages and salary, be terminated at any time without any prior notice.

Signature_____________________________              Date____________________

Please return application to:

Ground Affects Landscaping, Inc.
W1526 Froelich Rd.
Sullivan, WI 53178

EQUAL OPPORTUNITY EMPLOYER