Land Lords Landscaping is a Paver and Retaining Wall Contractor serving Gray Tennessee TN

Application for Employment

Date

Full Name

Social Security No.

- -

Driver's Licenses No.

Date of Birth

Address

Home Phone No.

Cell Phone No.

Position

Date you can start

Salary Desired

High School

Years Attended

Did you graduate

College

Years Attended

Did you Graduate

Related Work Experience

Years of Experience

Special Training/Skills

Former Employers

Name & Address
Salary	Position
Length of Employment	Reason for Leaving
References Name	Phone Number
Business	Years Known
References Name	Phone Number
Business	Years Known
References Name	Phone Number
Business	Years Known
"I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for dismissal. I authorize investigation of all statements contained herein and the references and employers listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release the company from all liability for any damage that may result for utilization of such information. I also understand and agree that no representative of the company has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing unless it is in writing and signed by an authorized company representative. This waiver does not permit the release or use of disability-related or medical information in a manner prohibited by the American with Disabilities Act (ADA) and other relevant federal and state laws."

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