The Plant People Inc. Is an equal opportunity employer. This application will not be used for limiting or excluding any applicant from consideration for employment on a basis prohibited by local, state or federal law. Should an applicant need reasonable accommodation in the application process, he or she should contact a company representative.
Please fill out all of the sections below:
Applicant Information
Applicant name: _____________________________________________________________
Address: _____________________________________________________________
City, State and Zip ____________________________________________________________
Code
____________________________________________________________
Telephone number: _____________________________________________________________
Email address: _____________________________________________________________
Date of Application: _____________________________________________________________
Employment Position
Position applying for: ____________________
How did you hear about this position? ______________________________________
What days are you available for work? ______________________________________
On what date can you start working if you are hired?______________________________________
Salary desired: ______________________________________
Personal Information
Have you ever applied to or worked for The Plant People Inc. Before? Yes No
If yes, when?
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Are you 18 years of age or older? Yes No
Are you a U.S. citizen or approved to work in the United States? Yes No
What document can you provide as proof of citizenship or legal status?
_____________________________________________________________________
_____________________________________________________________________
Do you have any conditions which would require job accommodation? Yes No
If yes, please describe accommodation required below.
_____________________________________________________________________
_____________________________________________________________________
Have you ever been convicted of a criminal offense (felony or misdemeanor)? Yes No
If yes, please state the nature of the crime(s), when and where convicted and disposition
of the case:
_____________________________________________________________________
_____________________________________________________________________
(Note: No applicant will be denied employment solely on the grounds of conviction of any criminal offense. The date of the offense, the nature of the offense, including any significant details that affect the description of the event, and the surrounding circumstances and the relevance of the offense to the position(s) applied for may, however be considered)
Job Skills/Qualifications
Please list below the skills and qualifications you possess for the position for which you are applying:
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(Note: The Plant People Inc. Complies with the ADA and considers reasonable accommodation measures that may be necessary for eligible applicants/employees to perform essential functions.)
Military
Are you a member of the Armed Services? __________________________
How many years did you serve? __________________________
What military skills do you possess that would be an asset for this position? __________________________________________________________________________________________________________________________________________________________________________
Previous Employment
Employer Name: __________________________________________
Job Title: __________________________________________
Supervisor Name: __________________________________________
Employer address: __________________________________________
Employer phone #: __________________________________________
Dates Employed: __________________________________________
Reason for leaving: __________________________________________
Employer Name: __________________________________________
Job Title: __________________________________________
Supervisor Name: __________________________________________
Employer address: __________________________________________
Employer phone #: __________________________________________
Dates Employed: __________________________________________
Reason for leaving: __________________________________________
Employer Name: __________________________________________
Job Title: __________________________________________
Supervisor Name: __________________________________________
Employer address: __________________________________________
Employer phone #: __________________________________________
Dates Employed: __________________________________________
Reason for leaving: __________________________________________
References
Please provide 2 personal and professional reference(s) below:
Name: ________________________________ Contact Information: ________________________
Name: ________________________________ Contact Information: ________________________
Additional Information:
Are you able to lift to 50 lbs. Yes or No
Are you able to climb ladders/work on a ladder. Yes or No
Are you able to work on your knees (planting/weeding). Yes or No
Are you able to carry two 8 – 10 # water cans. Yes or No
Are you able to be on your feet all day. Yes or No
At-WILL EMPLOYMENT
The relationship between you and The Plant People Inc. Is referred to as “employment at will.” This means that your employment can be terminated at any time for any reason with or without cause, with or without notice, by you or The Plant People Inc.. No representative of The Plant People Inc. has authority to enter into any agreement contrary to the foregoing “employment at will” relationship. You understand that your employment is “at will” and that you acknowledge that no oral or written statements or representations regarding your employment can alter your at-will employment status, except for a written statement signed by you and either our Executive Vice President/Human Resources or the Company’s President.
Applicant Signature: Dated:
_________________________________ ______________________________