Simpson’s Landscape and Property Maintenance 32 Deerhill Road • Waterford • Maine • 04088 call or text: 207.523.0694  Fax  207-583-9108 click: simpsonslandscaping@gmail.com | www.simpsonlandscaping.biz

EMPLOYMENT APPLICATION GENERAL INFORMATION

NAME: ________________________________________________________________

ADDRESS: ________________________________________________________________

DAY TIME PHONE NUMBER: __ _______________________________________________________

EVENING PHONE NUMBER: _________________________________________________________

SOCIAL SECURITY NUMBER: ___ ___ ___ - ___ ___ - ___ ___ ___ ___

DRIVER’S LICENSE NUMBER: ____________________________________

POSITION APPLYING FOR: ________________________________________________________

CHOOSE ONE: FULL TIME _________ PART TIME _________

EDUCATION

NAME OF HIGH SCHOOL: __________________________________________________________ YEARS ATTENDED: FROM __________________ TO ________________________ GRADUATED: YES ________________ NO _______________ G.E.D. ________________

NAME OF COLLEGE: _______________________________________________________________ YEARS ATTENDED: FROM __________________ TO ___________________________ GRADUATED: YES _________________ NO _______________ DEGREE ________________

NAME OF VOCATIONAL OR TRADE SCHOOL: _____________________________________ YEARS ATTENDED: FROM __________________ TO ______________________________ CERTIFICATION EARNED: _________________________________________________________

OTHER (EXPLAIN): _________________________________________________________________ EMPLOYMENT

CAN WE CONTACT ANY OF YOUR PREVIOUS EMPLOYERS? ______________

PRESENT OR MOST RECENT EMPLOYER: ________________________________________ POSITION : _________________________________________________________________________ PHONE NUMBER: _____________________________________________ SUPERVISOR NAME: _______________________________________________________________ EMPLOYED FROM _________________________ TO _______________________________ SALARY _____________________________________________________ REASON FOR LEAVING: ___________________________________________________________

PAST EMPLOYER: __________________________________________________________________ POSITION: __________________________________________________________________________ PHONE NUMBER: _______________________________________ SUPERVISOR NAME: _______________________________________________________________ EMPLOYED FROM _________________________ TO _______________________________ SALARY ______________________________________________________ REASON FOR LEAVING:____________________________________________________________

PAST EMPLOYER: __________________________________________________________________ POSITION: __________________________________________________________________________ PHONE NUMBER: _______________________________________ SUPERVISOR NAME: _______________________________________________________________ EMPLOYED FROM _________________________ TO _______________________________ SALARY ______________________________________________________ REASON FOR LEAVING:____________________________________________________________

PAST EMPLOYER: __________________________________________________________________ POSITION: __________________________________________________________________________ PHONE NUMBER: _______________________________________ SUPERVISOR NAME: _______________________________________________________________ EMPLOYED FROM _________________________ TO _______________________________ SALARY ______________________________________________________ REASON FOR LEAVING:____________________________________________________________

REFERENCES

NAME: _____________________________________________________________________ PHONE NUMBER: _________________________________________________________ EMPLOYER: _______________________________________________________________ RELATIONSHIP: ___________________________________________________________

NAME: _____________________________________________________________________ PHONE NUMBER: _________________________________________________________ EMPLOYER: _______________________________________________________________ RELATIONSHIP: ___________________________________________________________

SKILLS & QUALIFICATIONS

LIST THE DIFFERENT SKILLS AND QUALIFICATIONS YOU HAVE THAT PERTAIN TO THE POSITION YOU ARE SEEKING WITH THIS COMPANY.

I certify that the information I have provided in this employment application is accurate to the best of my knowledge. I understand that providing false information could eliminate the chance for employment with this company. I also authorize all persons, companies and institutions listed on this application to provide information to my potential employer.

___________________________________________ ___________________________ ​Signed