Employment Application

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Name*

First

Middle

Last

Street Address

City

State

ZIP Code

Email address*

Phone

Position Applied For

Date Available

Desired Salary

Are you a US Citizen?

Yes

If no, are you authorized to work in the US?

Yes

Have you ever worked for this company?

Yes

If so, when?

Education

High School

Address:

From

Graduate?

Yes

Degree

College

Address:

From

Graduate?

Yes

Degree

Other

Address:

From

Graduate?

Yes

Degree

List any foreign languages you can speak, read, and/or write?

Describe any specialized training, apprenticeship , skills, and extra-curricular activities.

List any professional, trade, business or civic activities and offices held.

Business References

Name

Company

Relationship

Phone

Address

Name

Company

Relationship

Phone

Address

Name

Company

Relationship

Phone

Address

Business References

Company

Address

Job Title

From:

To:

Reason For Leaving:

Phone

Supervisor

Responsibilities

Starting Salary

Ending Salary

May we contact your previous supervisor?

Yes

Company

Address

Job Title

From:

To:

Reason For Leaving:

Phone

Supervisor

Responsibilities

Starting Salary

Ending Salary

May we contact your previous supervisor?

Yes

Company

Address

Job Title

From:

To:

Reason For Leaving:

Phone

Supervisor

Responsibilities

Starting Salary

Ending Salary

May we contact your previous supervisor?

Yes

Military Service

Have you ever served in the military?*

Yes

Branch

From

Rank at Discharge

Type of Discharge:

Other than honorable, please explain:

Describe any job related training received in the United States Military:

Drug Testing Consent

First, MI, Last

understand that as a part of the pre-employment process as required by North Georgia Turf, Inc., I must submit to a urinalysis drug screening.

I do hereby voluntary consent to the sampling and submission for testing of my urine for the purpose of screening for the presence of illegal drugs. I understand that a negative result from this screening is a condition of employment.

I also understand that refusal to supply the necessary samples in a reasonable and timely manner or producing a positively confirmed test result for the presence of illegal drugs may result in my being denied employment. I understand that a refusal to submit to a drug screen or a confirmed positive test result indicating the presence of illegal drugs may bar me from securing employment with North Georgia Turf, Inc.

I authorize disclosure of the drug screen results by and between the testing laboratory and North Georgia Turf, Inc.

I understand that the results of the urinalysis will be available to me as soon as possible after receipt by North Georgia Turf, Inc.

I understand that North Georgia Turf, Inc. will select the testing laboratory and the cost of the urinalysis will be furnished by North Georgia Turf.

Retype your name as above to sign:*

Date*

Supporting Documents

Resume

Application Verification

I certify that answers given herein are true and complete to the best of my knowledge. I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision.
This application shall be considered active for a time period not to exceed 45 days.

I hereby understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with this organization is of an "at will" nature, which means the employee may resign at any time and the employer may discharge employee at any time with or without cause. It is further understood that this "at will" employment relationship may not be changed by any written document or by conduct unless such change is specifically acknowledged in writing by an authorized executive of this organization.

In the event of employment, I understand that false or misleading information given in my application or interview may result in discharge. I also understand that I am required to abide by all rules and regulations of the employer.

Type full name to sign*

Date*

I authorize you to make such investigations of my personal, employment, financial, or medical history and other related matters as may be necessary in arriving at an employment decision. (Generally, inquiries regarding medical history will be made only if and after conditional offer of employment has been extended.) I hereby release employers, schools, health care providers and other persons from all liability in responding to inquiries and releasing information in connections with my application. In the event of employment, I understand that false or misleading information given in my application or interview may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the company.

I understand that the information I provided regarding current and/or previous employers may be used, and those employer(s) will be contacted, for the purpose of investigating my safety performance history as required by 49 CFR 391.23(d) and (e). I understand that I have the right to:

Type full name to sign*

Date*

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