SHARON’S PLANTS LTD.
41-614 Waikupanaha St.
Waimanalo Hawaii. 96795
Employment Application Date:
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Name:
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SSN:
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Address:
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Phone:
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Driver’s license? [ ] Y or [ ] N License type:
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Education
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High School
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Did you graduate?
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College
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Did you graduate?
Course of study:
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Are you presently employed? If yes, where?
If no, why?
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What days and hours are you available to work:
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Date you can start? Desired salary:
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Are you applying for:
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Temporary work – such as summer or holiday work? [ ] Y or [ ] N
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Regular part-time work? [ ] Y or [ ] N
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Regular full-time work? [ ] Y or [ ] N
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Can you work on the weekends? [ ] Y or [ ] N Are you willing to work late if needed ? [ ] Y or [ ] N
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If hired, are you willing to submit to and pass a controlled substance test? [ ] Y or [ ] N
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How did you hear about this job?
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Why would you like to work at a plant nursery?
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Do you have any special skills or hobbies?
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Are you able to lift at least 40 lbs? Are you able to lift to at least 70 lbs?
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Do you have any medical or physical problems that may affect work?
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Have you ever been convicted of a criminal offense (felony or misdemeanor)? [ ] Y or [ ] N
If yes, please describe the crime - state nature of the crime(s), when and where convicted and disposition of the case.________________________________________________________________
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Work History
List your last three employers. Include company name, address, phone number, date of hire and date of last day worked, your job description/duties, rate of pay and reason for leaving.
Please Read and Initial Each Paragraph, then Sign Below
I certify that I have not purposely withheld any information that might adversely affect my chances for hiring. I attest to the fact that the answers given by me are true & correct to the best of my knowledge and ability. I understand that any omission (including any misstatement) of material fact on this application or on any document used to secure can be grounds for rejection of application or, if I am employed by this company, terms for my immediate expulsion from the company.
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I understand that if I am employed, my employment is not definite and can be terminated at any time either with or without prior notice, and by either me or the company.
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I permit the company to examine my references, record of employment, education record, and any other information I have provided. I authorize the references I have listed to disclose any information related to my work record and my professional experiences with them, without giving me prior notice of such disclosure. In addition, I release the company, my former employers & all other persons, corporations, partnerships & associations from any & all claims, demands or liabilities arising out of or in any way related to such examination or revelation.
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Applicant's Signature:______________________________
Date:_________________________________
