Employment Application 

 

Viking Lawn Care and Landscaping LLC

Po Box 2995

Surf City, NC 28445 

919-394-5095

 

Applicant Information

Full Name:

 

 

 

DOB:

 

 

Last

First

M.I.

 

 

 

Address:

 

 

 

Street Address

Apartment/Unit #

 

 

 

 

 

 

City

State

ZIP Code

 

Phone:

 

Email

 

 

Date Available:

 

Social Security No.:

 

Driver’s License #

 

 

Position Applied for:

 

 

Are you a citizen of the United States?

YES

NO

If no, are you authorized to work in the U.S.?

YES

 

NO

 

 

Have you ever worked for this company?

YES

 

NO

 

If yes, when?

 

 

Have you ever been convicted of a felony?

YES

 

NO

 

 

 

If yes, explain:

 

 

 

 

 

References

Please list 3  professional references.

Full Name:

 

Relationship:

 

Company:

 

Phone:

 

Address:

 

 

 

 

 

Full Name:

 

Relationship:

 

Company:

 

Phone:

 

Address:

 

 

 

 

 

Full Name:

 

Relationship:

 

Company:

 

Phone:

 

Address:

 
         

Previous Employment

Company:

 

Phone:

 

Address:

 

Supervisor:

 

 

Job Title:

 

Starting Salary:

$

Ending Salary:

$

 

Responsibilities:

 

 

From:

 

To:

 

Reason for Leaving:

 

 

May we contact your previous supervisor for a reference?

YES

 

NO

 

 

 

 

 

 

 

 

 

 

 

Company:

 

Phone:

 

Address:

 

Supervisor:

 

 

Job Title:

 

Starting Salary:

$

Ending Salary:

$

 

Responsibilities:

 

 

From:

 

To:

 

Reason for Leaving:

 

 

May we contact your previous supervisor for a reference?

YES

 

NO

 

 

 

 

 

 

 

 

 

 

 

Disclaimer and Signature

 

 

I certify that my answers are true and complete to the best of my knowledge.

If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.

 

 

 

 

Signature:

 

Date: