Online Application

Name *

First

Last *

Last

Email *

Home Phone *

Mobile Phone *

Address *

City *

State *

Postal Code *

Are you authorized to work in the U. S.? *

Yes

Do you use tobacco? *

Yes

Have you been convicted of a felony? *

Yes

(convictions will not necessarily disqualify an applicant from employment)

Do you have a valid drivers license? *

Yes

Do you have any tattoos? *

Yes

Whitmore's Yard Care has a policy regarding offensive tattoos and piercings.

Employment Desired

Position Applied for *

Date you can start *

Are you available for full time work? *

Yes

Are you available for part time work? *

Yes

In addition to your work history, please list all experiences, skills, or other qualifications related to our industry.

Are you available to work Saturday and Sunday? *

Yes

Starting salary desired? *

Professional References (not personal): List 3 people who can comment on your work performance. No friends or relatives should be listed.

Ref 1 Name *

Address *

Occupation *

Phone Number *

Years Aquainted *

Ref 2 Name

Address

Occupation

Phone Number

Years Aquainted

Ref 3 Name

Address

Occupation

Phone Number

Years Aquainted

Education

Name of School *

Location City *

State *

Did you graduate? *

Degree

Licenses and Certifications: List all professional licenses or certifications.

License *

License Number *

Expires

License

License Number

Expires

License

License Number

Expires

Employment: Complete all information in full history.

(A resume may not be substituted but may be included as a supplement) Begin with your most recent employment, including any present employment. Your present employer will not be contacted without your permission. You may include any verifiable work performed on a volunteer basis.

Are you employed now? *

Yes

Any gaps in employment must be briefly explained.

Company Name 1 *

Dates of employment *

Address *

Phone Number *

Job Title *

Supervisor *

May we contact them? *

Yes

Specific Duties *

Reason for leaving *

Company Name 2

Dates of employment

Address

Phone Number

Job Title

Supervisor

May we contact them?

Yes

Specific Duties

Reason for leaving

Company Name 3

Address

Dates of employment

Phone Number

Job Title

Supervisor

May we contact them?

Yes

Specific Duties

Reason for leaving

In case of emergency contact information.

Name:

Relationship

Phone Number

Address

City

State

Zip

PLEASE READ BEFORE SIGNING

I understand that unless I attain permanent status pursuant to MGL Chapter 31 or am subject to the terms of a collective bargaining agreement, my employment will be at-will, which means that both Whitmore's Yare Care, Inc. and I are free to terminate at any time for any reason non-statutorily prohibited reason or for no reason at all, with or without notice. I certify under the pains and penalty of perjury that all statements made by me on this application are true and complete to the best of my knowledge and that I have withheld nothing, which, if disclosed, would affect this application unfavorably. I understand that any false statements, omissions or answers made by me on this application can result in my immediate termination. Any applicant must have a valid drivers license, valid D.O.T. license, and a current Unattested Driving Record from the RMV. I hereby acknowledge that I have read in full and understand the above statements and conditions of employment.

Signature of Applicant

Name of Applicant

Date

You may also upload your resume in (PDF,Text,or Word format).

Maximum upload size: 104.86MB

A resume cannot be substituted but may be included to supplement your aplication.

*Please be patient as it may take a minute to process your form on the server.

508-378-2628

Employment Desired

Professional References (not personal): List 3 people who can comment on your work performance. No friends or relatives should be listed.

Education

Licenses and Certifications: List all professional licenses or certifications.

Employment: Complete all information in full history.

In case of emergency contact information.

PLEASE READ BEFORE SIGNING

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