Bay Country Employment Application
Please list below your last five employers, starting with the last one. Please fill out to completion.
Bay Country Landscape & Maintenance Co. requires that each employee is physically qualified to perform the tasks required by the job. As a condition of employment each employee may be required to take a physical examination as necessary for the safety and welfare of the employee or fellow employees.
Personal Data
Full Name
Phone Number
Social Security Number
Date of Birth
Are you a US Citizen?
If no, do you have a registration card or a valid US work permit?
Do you have a current valid driver's license?
Have you ever been convicted for a crime (other than traffic or other minor violations)?
If yes, please explain
Present Address
Address
City
State
Zip Code
Previous Address (if less than 3 years at present address)
Address
City
State
Zip Code
High School
School & Address
Date Graduated
Major
Degree
College
School & Address
Date Graduated
Major
Degree
Business School
School & Address
Date Graduated
Major
Degree
Technical School
School & Address
Date Graduated
Major
Degree
Military Service
Have you ever served in the US Armed Forces?
If yes, what was your...
Branch
Rank Attained
From
To
Honors or Awards
Special Training
Job Information
Position Preferred
Rate of Pay Acceptable
Date Available
Are you currently employed?
If yes, may we refer to your present employer?
Applying for:
Are you willing to travel out of state if needed?
Other special skills, knowledge or abilities, which support your qualifications for the position, which you are seeking
Previous Experience with Bay Country Landscape?
Have you ever worked for Bay Country Landscape or one of its subsidiaries?
If yes...
When?
Where?
Position?
Latest Employer
From
To
Name of Employer
Address of Employer
Phone Number of Employer
Salary
Position
Reason for Leaving
2nd Latest Employer
From
To
Name of Employer
Address of Employer
Phone Number of Employer
Salary
Position
Reason for Leaving
3rd Latest Employer
From
To
Name of Employer
Address of Employer
Phone Number of Employer
Salary
Position
Reason for Leaving
4th Latest Employer
From
To
Name of Employer
Address of Employer
Phone Number of Employer
Salary
Position
Reason for Leaving
5th Latest Employer
From
To
Name of Employer
Address of Employer
Phone Number of Employer
Salary
Position
Reason for Leaving
Medical Information
Do you have any disabilities?
If yes, explain
Have you ever been compensated for a work related injury?
If yes, please explain
Are you currently, or have you during the past six months been under the care of a physician?
If yes, please explain
Bay Country Landscape & Maintenance Co. requires that each employee is free from the effects of drugs or alcohol while performing the tasks required by the job. As a condition of employment, each employee may be required to take a drug-screening test at the time of employment, or at any other time at the discretion of the company. Each applicant must answer and agree to the following:
I have taken the following prescription or non-prescription drugs during the past 30 days:
I hereby consent to a pre-employment drug and alcohol-screening test, and certify that, to the best of my knowledge, the foregoing answers are complete and correct. I understand and agree that any omission of this record may be cause for the disqualification of my application, or termination. Furthermore, if employed, I hereby authorize Bay Country Landscape & Maintenance co. to require me to take drug and alcohol screening tests in accordance with the current company policy covering drug and alcohol abuse. I understand that my refusal to take drug screening tests as required by the current company policy shall result in my immediate discharge.
Signature
Today's Date
Reference 1 (Do not list relatives)
Name
Address
Phone Number
Estimated Years Known
Reference 2 (please do not list relatives)
Name
Address
Phone Number
Estimated Years Known
Reference 3 (please do not list relatives)
Name
Address
Phone Number
Estimated Years Known
Statement & Signature
In completing and submitting this application I understand and agree: That any misstatement of facts will be sufficient reason for immediate withdrawal of this application or, in the event of employment, is cause for termination. That my previous employers may be asked for information concerning my employment, character, ability and experience. That on this application, no question has been answered in such manner that can disclose any sex, race, color, religion, or national origin. That if employed, I may be required to furnish proof of age. I agree to abide by all rules/regulations set forth by Bay Country Landscape & Maintenance Co. That Bay Country Landscape & Maintenance Co. shall be entitled to receive reports concerning injury or illness from attending physicians and practitioners.
Signature
Today's Date
Contact Us
PHONE
(410) 398-0880
MAIL
P.O. Box 671, Elkton, MD 21922
Landscape Service Areas
DELAWARE
Dover, Lewes, Milton, Newark, Rehoboth Beach, Wilmington
MARYLAND
Elkton
PENNSYLVANIA
Boothwyn, Chadds Ford, Radnor
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