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
  • Job
  • Former
  • Medical
  • References

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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