J&D Landscaping & Lawn Care, Inc.

Employment Request

APPLICATION FOR EMPLOYMENT
Qualified applicants are considered for all positions without regard to race, color, sex, religion, age, national origin and disability. All questions must be answered and application signed. You can either complete this on-line application and/or print this form, complete it, sign it, and submit it to J&D Landscaping.

Date:

* First Name:

Last Name:

* E-Mail:

Address:

City:

State:

Zip:

Home Phone:

Business Phone:

Can you provide proof of US citizenship:

Y N

Employed by us before?:

Y N

If yes, when?:

Position wanted:

Starting salary expected:

Date available for employment:

Can you work on holidays:?

Y N

Are you 18 years of age or older?:

Y N

How did you learn of us?:

Have you been convicted of a felony? If yes, please explain:

Conviction of a crime will not necessarily disqualify you from the job for which you are applying. Each conviction will be considered with respect to time, job relatedness and other relevant factors.

WORK SCHEDULE
What shifts/hours are you available to work? We have shifts from 7:00 AM to 12:00 AM. (Please list hours in each AM/PM box).

SHIFT	MON	TUE	WED	THU	FRI	SAT	SUN
AM	to	to	to	to	to	to	to
PM	to	to	to	to	to	to	to

EDUCATION

Type of School	Name of School	Courses Majored In	Number of Years Completed	Degree or Diploma
High School
College

BUSINESS EXPERIENCE

Job 1 Previous Employer:	Phone:	Supervisor:	Job Title :
Previous / Current Employer Address: Street: City: State: Zip Code:
Your Position:	Reason for Leaving:
From / To: -	Salary: $

Job 2 Previous Employer:	Phone:	Supervisor:	Job Title :
Previous / Current Employer Address: Street: City: State: Zip Code:
Your Position:	Reason for Leaving:
From / To: -	Salary: $

Job 3 Previous Employer:	Phone:	Supervisor:	Job Title :
Previous / Current Employer Address: Street: City: State: Zip Code:
Your Position:	Reason for Leaving:
From / To: -	Salary: $

EMERGENCY CONTACT

Full Name:

Address / City / State / Zip:

Phone:

* Additional Comments:

I AFFIRM THAT ALL INFORMATION IN THIS APPLICATION IS TRUE AND COMPLETE. ANY MISREPRESENTATION, FALSE STATEMENT, OR OMISSION OF FACTS CALLED FOR SHALL BE GROUNDS FOR REFUSAL OF EMPLOYMENT OR IF HIRED, DISMISSAL FROM EMPLOYMENT. I UNDERSTAND THAT ANY VIOLATION OF COMPANY RULES, POLICIES, STANDARDS, AND/OR PROCEDURES SHALL BE GROUNDS FOR DISMISSAL. I AGREE TO CONFORM TO THE RULES, POLICIES, STANDARDS, AND REGULATIONS OF J&D LANDSCAPING, INC.. I UNDERSTAND THAT MY EMPLOYMENT AND COMPENSATION CAN BE TERMINATED WITH OR WITHOUT CAUSE, AND WITH OR WITHOUT NOTICE, AT ANY TIME AT THE OPTION OF HEROICA'S PAINTING, AND I UNDERSTAND THAT NO REPRESENTATIVE OF THE COMPANY HAS THE AUTHORITY TO MAKE ANY MODIFICATIONS, EITHER VERBALLY OR IN WRITING TO THE CONTRARY.

IT IS THE POLICY OF HEROICA'S PAINTING TO HIRE ONLY U.S. CITIZENS AND ALIENS WHO ARE LAWFULLY AUTHORIZED TO WORK IN THE UNITED STATES. ALL EMPLOYEES WILL BE ASKED TO VERIFY EMPLOYMENT ELIGIBILITY PRIOR TO BEGINNING WORK.

I UNDERSTAND THAT MY APPLICATION WILL REMAIN ACTIVE FOR 30 DAYS FROM THE DATE RECEIVED.

* Required