Employment Application

Green Site Services Group Inc. is an equal opportunity employer. This application will not be used for limiting or excluding any applicant from consideration for employment on a basis prohibited by local, state, or federal law. Should an applicant need reasonable accommodation in the application process, he/she should contact a company representative.

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Step 1 of 11

Applicant Information

Name*

First Last

Address*

Street Address Address Line 2 City State ZIP Code

Phone*

Email*

Date of Birth*

Month

Day

Year

Employment Position

Position(s) applying for

How did you hear about this position?

What days are you available for work?

What hours or shifts are you available for work?

If needed, are you available to work overtime?

On what date can you start working if hired?

Month

Day

Year

Do you have a legal and functional vehicle?

Personal Information

Are you 18 years of age or older?

Are you a U.S. citizen or approved to work in the United States?

Are you able to provide document(s) as proof of citizenship or legal status?

Will you consent to a mandatory controlled substance test?

Have you had any vehicle accidents in the past three years?

Do you have any condition(s) which would require job accommodations?

Have you ever been convicted of a criminal offense (felony or misdemeanor)?

Job Skills/Qualifications

Please list below the skills and qualifications you possess for the position for which you are applying:

Education and Training

High School Name

High School Location

High School Year Graduated

High School Degree Earned

College/University Name

College/University Location

College/University Year Graduated

College/University Degree Earned

Skills

Operating System

Are you proficient in Microsoft Office Programs?

If yes, which ones?

Military

Are you a member of the Armed Services?

Are you a veteran / protected veteran?

Are you currently a member of a National Guard or State Defense Force Unit?

Previous Employment

May we contact your current or most recent employer?

Position #1

Employer Name

Job Title

Supervisor Name

Employer Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Employer Phone

Date Employed From

MM slash DD slash YYYY

Date Employed To

MM slash DD slash YYYY

Reasons for Leaving

Position #2

Employer Name

Job Title

Supervisor Name

Employer Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Employer Phone

Date Employed From

MM slash DD slash YYYY

Date Employed To

MM slash DD slash YYYY

Reasons for Leaving

Position #3

Employer Name

Job Title

Supervisor Name

Employer Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Employer Phone

Date Employed From

MM slash DD slash YYYY

Date Employed To

MM slash DD slash YYYY

Reasons for Leaving

References

Reference 1

Phone

Reference 2

Phone

Reference 3

Phone

Emergency Contact Information

Name

First Last

Relationship

Phone

AT-WILL-EMPLOYMENT

The relationship between you and Green Site Services Group Inc. is referred to as “employment at will”. This means that your employment may be terminated at any time for any reason, with or without cause, with or without notice, by you or the company. No representative of the company has authority to enter into any agreement contrary to the forgoing “employment at will” relationship. You understand that your employment is “at will” and that you acknowledge that no oral or written statements or representations regarding your employment can alter your at-will employment status, except for a written statement signed by you and the company’s President.

Signature*

Date

Month

Day

Year