Employment Application

NOTE: Please Fill out the application completely and entirely. Any application not filled out completely will be automatically deleted. Premier Tree & Shrub Care is a DRUG FREE company.

First Name: *
Middle Name: *
Last Name: *
Social Security No. *
Address: *
City: *
State/Province: *
Zip/Postal Code: *
Email Address: *
Date of Birth *
Home Phone: *
Position Desired: *
Date You Can Start: *
Hourly Rate Desired: *
Are you currently employed? *
If so, may we contact your employer? *
Have you ever applied for a job with this company before? *
Did you graduate high school? *
Subjects of special study/research work or special training/skills *
Have you ever been convicted of a crime?(DUIs and misdemeanors are crimes too.) *
If yes, please explain. (Must give some explanation, no explanation means no interview). *
U.S. Military or Naval Service(if yes, what rank)? *
Do you have a valid driver's license? *
Do you have a CDL? *
Have you had any tickets on your driving record in the last 7 years? If so, list each. *
Are you a certified Arborist? *
Are you a GA Licensed pesticide applicator? *
Do you have or have had any allergic reactions to plants or pest bites such as, Poison Ivy or Bee Stings? *
Have you ever had a major injury or illness that may affect your ability to do your job? If so, please explain.(All positions will require heavy lifting. We do not want anyone to injure or re-injure themselves.) *
List two former employers, (starting with last one first.) Be sure to include Name & Phone number of employer, salary, position, supervisors name, and your reason for leaving. Please separate by slash *
Give the names of three people, not related to you, whom have known you for at least one year as your references. Separate by slash. Be sure you include phone numbers. *
How did you find out about this employment opportunity?  
If you were referred by a current employee of Premier Tree and Shrub Care, please list their first and last name: *

I certify that the facts contained in this application and true and complete 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 from utilization of such information.

I understand that I am not required to fill out any or all of this application and any information I disclose is done so at my own free will. I also understand that leaving any item blank could result in not being offered a position with Premier Tree & Shrub Care LLC.

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 Americans with Disabilities Act (ADA) and other relevant federal and state laws.