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1 PLEASE PR.NT ALL R & R Tree Ser'l'tic:e Inc FOR EMil CIYII'IENT APPLICANTS MAY BE TESTED F":I~ ILLEGAL DRUGS I I PLEASE COMPLETE PAGES 1-5. DATE last First Present address How long Number Street Middle Ciy State Zip So:c at Security No. Maiden Telephone.l( 1. If under 18, please list age Datu I)fBirth: Position applied for (1) and salary desired (2) (Be specific) Days/hours available to work No Pref. Thur MOI~ Fri Tue Sat We:l Sun How many hours can you work weekly? Can you work nights? Employment desired ClFULL-TIME ONLY ClPART-TIME I::I-JLY I:IFULL- OR PART-TIME When available for work? TYPE OF SCHOOL NAME OF SCHOOL LOCATION (Complete mailing address) HiQh School NUMBER OF YEARS MAJOR & COMPLETED DEGREE Colleoe Bus. or Trade School Professional Schoo!. HAVE YOU EVER BEEN CONVICTED OF A CRIME? CI No Cl Yes If yes, explain number of conviction(s), nature of offensejs) leading to ccnvictiorus), how recently such offense(s) wasfwere committed, sentence(s) imposed, and type(s) of rehabilitation.
2 FOR EM :'I.()YMENT ~~~ DO YOU HAVE A DRIVER'S LICENSE? What is your means of transportation to work? Driver's license number Expiration date State of issue CI Operator 0 Commercial (CDL) OChauffeur Have you had any accidents during the past three years? Have you had any moving violations during the past three years? How many? How Many? Typing WPM 10-key Word Processing DNo WPM Personal Computer PC Mac o o Other Skills Please list two references other than relatives or previous employers. Position Company Cornp.siy Addre.u Telephone "'- ) An application form sometimes makes it difficult for an individual to ade ;.iatei\, summarize a complete background. Use the space below to summarize any additional information necessary to descii bl~your full qualifications for the specific position for which you are applying.
3 FOR EM :'I.()YJJlENT MILITARY ~J' HAVE YOU EVER BEEN IN THE ARMED FORCES? () No ARE YOU NOW A MEMBER OF THE NATIONAL GUARD? CI Yes 0 No I Specialty Date Entered. Discharge Date Work Experience Please list your work experience for the past five ye~ i'!~ be::linning with your most recent job held. If you were self-employed, give firm name. Attach al!:litional sheets if necessary. ~~ Na~"e of stlnelvi! /- last Employment dates Payor salary ior. Your l.s it ob title Reason for leaving (be specific) list the jobs you held, duties performed, skills used or learned, advanounent ::;or promotions while you worked at this Reason for leaving (be specific) - Narl :.(If J;= 1st Employment dates Payor salary SUI)' :r"isl :.r - Your L<I»t Jot J Title List the jobs you held, duties performed, skills used or learned, advance nents or promotions while you worked at this
4 FOR EM~':'OYMENT Work experience Reason for leaving (be specific) Please list your work experience for the past five ye. ns J)e!;!inning with your most recentjob held. If you were self-employed, give firm name. Attach all :Iitional sheets if necessary. ~ J List the jobs you held, duties performed, skills used or learned, advano. Nar de of.iast Employment dates Payor salary Sli iervis or Your I.tiot i title s or promotions while you worked at this Reason for leaving (be specific) Nat-,;~of Ii:,st Employment dates Payor salary suo-,::i"'lis( If Your Ie sr.job title List the jobs you held, duties performed, skills used or learned, advance re rts; or promotions while you worked at this May we contact your present employer? Q Yes Cl No Did you complete this application yourself 0 Yes 0 No If not, who did?
5 PLEASE READ CAREFUL~I' FORM WAI~I:R In exchange for the consideration of my job application by (hereinafter called "the Company"), I agree that: Neither the acceptance of this application nor the subsequent entry mto any type of employment relationship, either in the position applied for or any other position, 3 'Id reqardless of the contents of employee handbooks, personnel manuals, benefit plans, policy stacnents, and the like as they may exist from time to time, or other Company practices, shall serve to create,10 actual or implied contract of employment, or to confer any right to remain an employee of. ' or otherwise to change in any respect the employment-at-will relationship between it and the underslqned, and that relationship cannot be altered except by a written instrument signed by the President/Germe I Manager of the Company. Both the undersigned and may end the employment relations j- p at any time, without specified notice or reason If employed, I understand that the Company may unilatnal y cnanqe or revise their benefits, policies and procedures and such changes may include reduction i-oenefits. I authorize investigation of all statements contained in this applicati )11. l t.nderstand that the misrepresentation or omission of facts called for is cause for dismiss 031 at any time without any previous notice. I hereby give the Company permission to contact schools, ; 'evious employers (unless otherwise indicated), references, and others, and hereby release the Compar :. from any liability as a result of such contract. I also understand that (1) the Company has a drug and alcohol pol [I' that provides for preemployment testing as well as testing after employment; (2) consent to and corr I ianee with such policy is a condition of my employment; and (3) continued employment is based on the successtul passing of testing under such policy. I further understand that continued employment may be ba ; :d on the successful passing of jobrelated physical examinations. I understand that, in connection with the routine processing of your,~mpl()yment application, the Company may request from a consumer reporting agency an investigative corsumer report including information as to my credit records, character, general reputation, personal character.sties, and mode of living. Upon written request from me, the Company, will provide me with additional info' 11<:tien concerning the nature and scope of any such report requested by it, as required by the Fair Credit R ;»ortinq Act. I further understand that my employment with the Company shall b: probationary for a period of sixty (60) days, and further that at any time during the probationary period or thereafter, my employment relation with the Company is terminable at will for any reason by either party. Signature of applicant'. Date: This Company is an equal employment opportunity employer. We c.:!hem to a policy of making employment decisions without regard to race, color, religion, sex, sexual oriente! or, national origin, citizenship, age or disability. We assure you that your opportunity for employment wit -, this Company depends solely on your qualifications. Thank you for completing this application form and for YOII,' ir terest in our business.
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