Employment - PrettyGrass

Name*

First

Last

Application Date*

Month

Day

Year

Address*

Address Line 1

Address Line 2

City

State

Postal Code

Phone Number*

1. GENERAL INFORMATIONAre you able to perform the essential job functions of the position for which you are applying with or without reasonable accomodation?*

Yes

Have you been convicted of any felonies other than minor traffic violations during the past seven years? *

Yes

If yes, explain:

2. EDUCATION & TRAINING

Last Grade Completed:

Last High School Attended/Address:

Graduated or Degree?

Yes

Average Grade:

College or University/Address:

Graduated or Degree?

Yes

Average Grade:

Other School/Address:

Graduated or Degree?

Yes

Average Grade

List any scholarships, academic honors, awards or special achievements:

3. SKILLSHelp users with some text.

Please list any skills you have that are appropriate for the position you are applying for:*

If required, will you work Rotating Shifts?

Yes

Overtime?

Yes

Saturdays?

Yes

Position Applying for, be specific:*

Salary Requirements:*

Per hour

Per month

State fully why you believe you are qualified for this position:

Interests / Accomplishments:

Date you can start:*

Month

Day

Year

EMPLOYMENT HISTORYStarting with your PRESENT or MOST RECENT EMPLOYER list in consecutive order ALL EMPLOYMENT for at least the past FOUR employers.If currently employed, may we contact your employer?

Yes

PRESENT OF MOST RECENT EMPLOYER

Full name of Company:

Street Address

Address Line 1

Address Line 2

City

State

Postal Code

Phone Number

Name & Title of Supervisor

Title of your Position

Reason for Leaving:

Salary BEGIN

Salary End

Employed FROM

Month

Day

Year

Employed TO

Month

Day

Year

List jobs held, duties performed, skills used, & promotions while employed at this company:

Employer #2

Full name of Company:

Street Address

Address Line 1

Address Line 2

City

State

Postal Code

Name & Title of Supervisor

Title of your Position

Reason for Leaving:

Salary BEGIN

Salary End

Employed FROM

Month

Day

Year

Employed TO

Month

Day

Year

List jobs held, duties performed, skills used, & promotions while employed at this company:

Employer #3

Full name of Company:

Street Address

Address Line 1

Address Line 2

City

State

Postal Code

Name & Title of Supervisor

Title of your Position

Reason for Leaving:

Salary BEGIN

Salary End

Employed FROM

Month

Day

Year

Employed TO

Month

Day

Year

List jobs held, duties performed, skills used, & promotions while employed at this company:

READ CAREFULLY: I certify that the information contained in this application is correct to the best of my knowledge and understand that any misstatement or omission of information may result in denial of employment or discharge. I authorize 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.

Name*

Date*

Month

Day

Year