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Groundsperson Application
mike
2022-05-24T20:58:39+00:00
Step
1
of
8
- Basic Information
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Basic Information
Date you can start
MM slash DD slash YYYY
Salary desired
*
Name
*
First
Last
Home Phone
Address
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Mobile Phone
Email
*
Are you 21 or older?
*
Yes
No
Do you have a CA driver's license?
*
Yes
No
Are you able to drive a manual transmission?
*
Yes
No
Q & A
Do you have relatives working for this company?
*
No
Yes
If yes, list their names below
*
How were you referred to this company?
*
Have you worked for this company before?
*
No
Yes
Are you anticipating absences away from work of any duration?
*
No
Yes
If yes, explain below
*
Are you available to work overtime, if necessary?
*
Yes
No
Are you available to work on weekends?
*
Yes
No
Do you have a reliable means of transportation to and from work?
*
Yes
No
Do you have a valid driver’s license?
*
No
Yes
If yes, provide #, state and Exp. Date:
If driving is a requirement of the position applied for, have you had your license suspended or revoked in the last 3 years? *
*
No
Yes
If YES, please explain:
Availability to work:
*
Full-time
Part-time
Temp
Are you 18 years old or older?
*
No
Yes
If hired, can you show proof of age or provide a permit to work? You will be required to do so after employment.
*
Yes
No
If hired, can you show proof of your legal right to work in the United States? You will be required to do so after employment.
*
Yes
No
Have you been convicted of any felony within the past seven (7) years? (A conviction is not an automatic bar to employment. Each case will be considered on it’s own merits.)
*
No
Yes
If yes, explain below
*
If required, will you undergo a Pre-Employment Physical and Drug Test?
*
Yes
No
References
Reference Name 1
*
Reference Phone
*
Relationship
Reference Name 2
*
Reference Phone
*
Relationship
Reference Name 3
*
Reference Phone
*
Relationship
Education
Did you attend Primary Education (High School)?
*
No
Yes
What is your major?
*
Number of years completed
*
Did you graduate?
*
Did you attend Vocational/Technical?
*
No
Yes
What is your major?
*
Number of years completed
*
Did you graduate?
*
Did you attend College/University?
*
No
Yes
What is your major?
*
Number of years completed
*
Did you graduate?
*
Past Work Experience
List Three Most Recent Positions Held (Starting with last position held) Do not leave out any former employer. Your employment history will be verified.
Name of current or last employer:
*
Previous Job Title
*
Date Previous Job Started
*
MM slash DD slash YYYY
Date Previous Job Ended
*
MM slash DD slash YYYY
Name of your immediate supervisor?
*
May we contact this employer?
*
Yes
No
Previous Job Description
*
List some of your duties, your starting and final rate of pay, why did you leave?
Name of last employer:
*
Previous Job Title
*
Date Previous Job Started
*
MM slash DD slash YYYY
Date Previous Job Ended
*
MM slash DD slash YYYY
Name of your immediate supervisor?
*
May we contact this employer?
*
Yes
No
Previous Job Description
*
List some of your duties, your starting and final rate of pay, why did you leave?
Name of last employer:
Previous Job Title
Date Previous Job Started
MM slash DD slash YYYY
Date Previous Job Ended
MM slash DD slash YYYY
Name of your immediate supervisor?
May we contact this employer?
Yes
No
Previous Job Description
List some of your duties, your starting and final rate of pay, why did you leave?
I was unemployed for more than one month:
Please identify and explain all periods of unemployment of more than one month during the past 3 years. Do not include any period of unemployment due to pregnancy or other medical reasons.
I was unemployed from
MM slash DD slash YYYY
I was unemployed to
MM slash DD slash YYYY
Because
I was unemployed from
MM slash DD slash YYYY
I was unemployed to
MM slash DD slash YYYY
Because
I was unemployed from
MM slash DD slash YYYY
I was unemployed to
MM slash DD slash YYYY
Because
Skills
Office/Clerical Skills
*
Calculator
Data Entry
Multi-Line Phone System
Copy Machine/Fax
Typing
Customer Service Call Handling
None of the Above
Computer Skills Please List Hardware & Software:
Production Skills (All Production Positions)
*
Tree Climbing w/Spurs
Tree Climbing w/out Spurs
Stump Grinder
Chain Saw
Wood Chipper
Bucket Truck
Traffic Control/Flagger
None of the Above
Do you have any other experience doing tree work?
*
No
Yes
If your answer is yes, please describe any additional training, experience and the total number of years. Experience that you have:
Are you trained and currently certified in Line Clearance Tree Trimming?
*
No
Yes
If your answer is yes, when and by whom?
Do you have practical experience in line clearance tree trimming?
*
No
Yes
If your answer is yes, How long and where?
Driving Skills (Positions requiring driving)
*
Automatic Transmission
Two-speed rear axle
Truck and wood Chipper
Manual multi-speed Trans.
1-ton truck
Bucket truck
2-ton truck
Check all those that you have experience operating.
Commercial Driver's License:
*
Yes
No
State and license number:
*
Driving Information
Accident Date (skip if not applicable)
MM slash DD slash YYYY
Nature Of Accident (Head-On, Rear-End, Etc)
Fatalities
Yes
No
Injuries
Yes
No
Accident Date (skip if not applicable)
MM slash DD slash YYYY
Nature Of Accident (Head-On, Rear-End, Etc)
Fatalities
Yes
No
Injuries
Yes
No
Have you ever been denied a license, permit or privilege to operate a motor vehicle?
*
Yes
No
Has any license, permit or privilege ever been suspended or revoked?
*
Yes
No
Acknowledgement of Physical, Mental and Medical Requirements
I understand that if I am extended an offer of employment, it may be conditioned upon my successfully passing a pre-employment alcohol and drug screening examination. I understand that my job offer or my continuing employment, if hired, is contingent upon my being physically, mentally and medically able, with or without reasonable accommodation, to successfully perform the essential functions of my job. I consent to the release of any or all medical information as may be deemed necessary to judge my capability to do the work for which I am applying.
All production positions are physically demanding. Entry-level Employees in these positions are expected, within a reasonable time after they commence employment, to be able to do tree work. This work includes climbing trees and removing tree limbs using various hand and power tools on a continuous basis during an eight to ten hour shift; removing and disposing of tree limbs using various mechanized tools, which can require lifting and carrying up to 75 pounds. Most entry-level employees may also be required to obtain state licenses to apply pesticides and engage in duties that require exposure to various chemicals and pesticides.
Do you understand the requirements for the position?
*
I do
I do not
I understand that if I am extended an offer of employment, it may be conditioned upon my successfully passing a pre-employment alcohol and drug screening examination. I understand that my job offer or my continuing employment, if hired, is contingent upon my being physically, mentally and medically able, with or without reasonable accommodation, to successfully perform the essential functions of my job. I consent to the release of any or all medical information as may be deemed necessary to judge my capability to do the work for which I am applying.
Are you physically able to safely perform these job duties with or without a reasonable accommodation?
*
I am
I am not
Signature
*
Phone
This field is for validation purposes and should be left unchanged.
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