APPLICATION FOR EMPLOYMENT (SOLICITUD DE EMPLEO)

Transcripción

1 Office Use Only: APPLICATION FOR EMPLOYMENT (SOLICITUD DE EMPLEO) PERSONAL INFORMATION (Datos Personales) DATE (Fecha): NAME (Nombre) Address (dirección): Street (Calle) City (Ciudad) State (Estado) Zip Code (Código Postal) Phone (Teléfono): Are you 18 years or older? YES/NO Cellular (Celular): ( Tiene más de 18 años de edad?) SI/NO Proof of Identity and Eligibility Will Be Required Upon Employment (Al ser contratado, se requiere que compruebe su identidad) If hired, can you prove that you have the lawful right to work in this country? YES/NO Si usted es contratado puede comprobar tener derecho legal trabajar en este país? SI/NO Have you ever been convicted of a crime or violation other than a minor traffic violation? YES/NO Ha sido condenado por un crimen o infracción fuera de una infracción de tráfico? SI/NO If yes, please explain, listing county of violation: Si contesto si, explique, condado de listado de violacion: A conviction record will not necessarily be a bar to employment. Factors such as job relations, age and time of the offense, seriousness and nature of violation and rehabilitation will be taken into account. No es necesario que los antecedentes penales sean barreras al empleo. Se toman en cuentan factores tales como el puesto, edad al tiempo de cometer la ofensa, la gravedad y tipo de infracción y rehabilitación. EMPLOYMENT DESIRED (Tipo De Trabajo Que Solicita) Position: Available Start Date: Pay Rate Desired: (Puesto Solicitado) (Fecha que está disponible para comenzar) (Salario desado) Are you employed now? YES/NO May we contact your present employer? YES/NO ( Tiene trabajo actualmente?) SI/NO ( Podemos ponernos en contacto con su empleador actual?) SI/NO Have you applied or been employed by our company before? YES/NO When? ( Ha solicitado empleo con Grunder o ha trabajado aquí anteriormente?) SI/NO ( Si contesto si, cuando?) How were you referred to our company? ( Quién lo refirió a nuestra compañía?) EDUCATION/SPECIAL TRAINING (Educación/Entrenamiento Especial) Name of School Number of Years in School Subjects Studied Graduated? (Graduado?) (Nombre de escuela) (Numero de anos cumplido (Tipo de Materias YES/NO SI/NO en la escuela) Estudiadas)

2 What are you available to work? ( Cual es su tiempo disponible para trabajar?) Full Time (Tiempo completo) Part Time (Tiempo parcial) If part time, what hours would you be available? ( Si es tiempo parcial, que horas estará disponible?) FORMER EMPLOYERS (TRABAJOS ANTERIORES) Most recent first (El Más Reciente Primero) Dates (month/year) Company Name Salary Position Reason for leaving (Fechas Mes/Ano) (Nombre de la Compañía) (Sueldo) (Puesto) (Por que dejo el trabajo) MILITARY SERVICE (Servicio Militar) Branch of Service & Serial Number (Sucursal de Servicio y No. de serie) Present Selective Service Classification (Presente Clasificación Selectiva de Servicio) Rank at Discharge (Rango al ser dado de alta) List Duties/Special Training (Deberes de lista/formación especial): Your position might require driving, so please complete this section. (Si el puesto requiere que conduzca, favor de llenar esta sección) Drivers License #: State: CDL: Class: (Numero de Licencia para Conducir) (Estado) (Licencia Comercial) (Clase) List any moving violation tickets received in the past (3) years: (Anote cualquier infracción de tráfico o multa recibida en los últimos 3 anos) *Note: By law, depending upon size of vehicle you may be required to drive, a physical exam may be required which may include drug testing. *Nota: Por la ley, dependiendo del tamaño del vehículo que usted va a conducir, es posible que se requiera someterse a un chequeo físico, lo cual incluiría una prueba de drogas. SPECIAL SKILLS & QUALIFICATIONS (Habilidades especiales y calificaciones) Summarize special skills and qualifications acquired from employment or other experience: What foreign languages do you speak, read and/or write?

3 AGREEMENT The facts set forth above in my application for employment are true and complete. I understand that false statements or omission of information on this application or any other employment form may lead to dismissal or denial of employment. You are hereby authorized to make any investigation of my personal history, financial, criminal, credit and motor vehicle records through any investigative or credit agencies or bureaus of your choice. You are also authorized to administer personality profile tests and verify my background. A criminal record or sentence is not an automatic disqualification for employment. I agree to submit to any drug or alcohol testing prior to or after employment and I agree to submit to a medical evaluation, if required. In making this application for employment, I also understand that an investigative consumer report may be made whereby information is obtained through personal interviews with my neighbors, friends or others with whom I am acquainted. This inquiry includes information as to my character, general reputation, personal characteristics and mod of living. I understand that I have the right to make a written request within a reasonable period of time to receive additional, detailed information about the nature and scope of this investigative consumer report. In exchange for the consideration of my employment application by this company, I hereby release and forever discharge the company (including its directors, officers, employees and agents) and my past and/or present employers (their directors, officers, employees and agents) from any liabilities which may result from an investigation of my past and/or present employment or from the disclosure of such information. I authorize the use of any information in this application to verify my statements, and I authorize the past employers, doctors, all references and any other persons to answer all questions asked concerning my ability, character, reputation and previous employment record. I understand that if my application is accepted that employment with this company at all times is employment at will. It is further understood that this at will relationship may not be changed by any written document, verbal statements, or by conduct unless such change is specifically acknowledged by an authorized executive of the company. I further understand that my at will employment may be terminated at any time by myself or the company and includes no guarantee, contract or promise of employment for any specific length of time. I understand that the first ninety (90) days of employment is a new hire introductory period. ACUERDO Los hechos expuestos anteriormente en mi aplicación de empleo son ciertos y completos. Entiendo que declaraciones falsas u omisión de información en esta aplicación o cualquier otro documento de empleo puede conllevar a la pérdida o negación del empleo. Usted está autorizado a realizar cualquier investigación de mi historia personal, financiera, criminal, crediticia, documentos de vehículos automotores a través de cualquier agencia de investigación o crediticia o el departamento de su escogencia. Usted está también autorizado para administrar un examen de perfil de personalidad y verificar mi pasado. Un archivo criminal o sentencia no es una descalificación automática de empleo. Yo acepto someterme a un examen de drogas o alcohol prioritario o posterior al empleo y acepto someterme a una evaluación médica. Presentando esta aplicación de empleo, también entiendo que un reporte de investigación al consumidor podría ser efectuado donde la información es obtenida a través de entrevistas personales con mis vecinos, amigos u otros quienes me conocen. Este cuestionario incluye información con respecto a mi carácter, reputación general, características personales y modo de vida. Entiendo que tengo el derecho de hacer una petición por escrito, dentro de un periodo de tiempo razonable para recibir información adicional detallada, acerca de la naturaleza y alcance de este reporte al consumidor. A cambio de que se considere mi aplicación de empleo por esta compañía, yo, aquí, libero y descargo a la compañía (incluyendo sus directores, oficiales, empleados y agentes) y mis pasados y presentes empleadores (sus directores, oficiales, empleados y agentes) de cualquier responsabilidad que pueda resultar de una investigación de mi pasado y/o presente empleo o de la exposición de tal información. Autorizo el uso de cualquier información en esta aplicación para verificar mis declaraciones, y autorizo a mis pasados empleadores, doctores, a quienes mencione como referencias y cualquier otra persona para responder todas las preguntas con respecto a mi habilidad, carácter, reputación y previos documentos de empleo. Entiendo que si mi aplicación es aceptada, este empleo con esta compañía es un empleo a voluntad. Se entiende además, que esta relación a voluntad no puede ser cambiada por un documento escrito, declaración verbal, o por una conducta a menos que tal cambio sea específicamente conocido por un ejecutivo autorizado de la compañía. Además, entiendo que mi empleo a voluntad puede ser terminado en cualquier momento por mi mismo o por la compañía y no incluye garantía, contrato o promesa de empleo por ningún periodo de tiempo especifico. Entiendo que los primeros 90 días de empleo, son un periodo introductorio como nuevo empleado. DATE: (Fecha) SIGNATURE: (Firma) Thank you for considering Southern Landscape Group, Inc. for employment Gracia por considerar a Southern Landscape Group, Inc. para el emple THIS IS A DRUG FREE WORKPLACE

4 Pre-Screening For Crew Member Applicants Name: Nombre: Please Indicate Your Landscape Skills (Favor de Indicar Su Nivel en Cada Habilidad en Jardinería) Maintenance Skills Habilidades en Mantenimiento Never Nunca Some Un Poco Expert Experto Construction Skills Habilidades en Construcción Push Mower Planting Trees/Shrubs Cortacésped Chiquito Plantar Árboles/Arbustos Walk Behind Mower B & B Trees/Shrubs Cortacésped Grande Encostalar Bola de Árboles y Arbustos String Trimmer Timber Work Cortadora de Orilla Trabajo con Vigas 8 Secciones Pruning Boulder Work Podar Trabajo con Piedras Redondas Chemical Application Bluestone Installation Aplicación de Productos Químicos Instalación de Piedra Plana Azul Core-Aeration Flagstone Installation Cultivar un jardín Instalación de Enlosa Perennial & Rose Care Masonry Work Cuidado de Rosas y Perennes Trabajo de Albañilería Drive Small Dump Truck Read Landscape Plan Conducir Camión Pequeño de Volteo Leer Planes de Jardinería Irrigation Work Grading Trabajo de Irrigación Trabajo en Desniveles Electrical Work Lead Construction Crew Trabajo Eléctrico Dirigir un Grupo de Construcción Snow Plow Operate Backhoe Limpiar Nieve con Camión Operar Maquina para Hacer Aberturas Lead Maintenance Crew Operate Skid Steer Loader Dirigir un Grupo de Mantenimiento Operar un Tractor Pequeño (Bob Cat) Garden Work Trabajo en Jardín Never Nunca Some Un Poco Expert Experto Drive Large Truck Conducir un Camión Grande Thank you for considering Southern Landscape Group, Inc. for employment Gracia por considerar a Southern Landscape Group, Inc. para el empleo Both parties have discussed the skills of the applicant and made the appropriate checkmarks to indicate the level of knowledge and agree by initialing here. Interviewer s Initials: Applicant s Initials:

5 BACKGROUND INQUIRY RELEASE FORM I, the undersigned applicant, do hereby certify that all information provided by me for the purpose of employment is true and complete to the best of my knowledge. I understand that falsification of any information on company documents may lead to denial of employment or termination. In connection with my application for employment, I understand that investigative background inquiries will be made on me, including consumer credit, education verification, criminal convictions, motor vehicle, workers' compensation, and others. These reports will include information as to my character, general reputation, work habits, performance and experience, along with reasons for termination of employment from previous employers. Further, I understand that you will be requesting information from various federal, state, and other agencies that maintain records concerning my past activities relating to me driving, credit, criminal, civil, and other experiences. I authorize, without reservation, any party or agency contacted by Southern Landscape Group, Inc. or its agents, to furnish the above-mentioned information prior to or at any time during my employment. The information on this form will be used solely for the purpose of conducting background checks and maintained in a confidential file. I hereby release all of the persons and agencies providing such information from any and all claims, damages or liabilities connected with their release of any requested information. I agree that any copy of this document is as valid as the original. I do hereby agree to forever release and discharge Southern Landscape Group, Inc. to the full extent permitted by law from any claims, damages, losses, liabilities, costs and expenses, or any other charge or complaint filed with any agency arising from the retrieval and reporting of information. According to the Federal Fair Credit Reporting Act, I am entitled to know if employment was denied based on information contained in a consumer credit report. I understand that to aid in the proper identification of my file or records, the following information is necessary: (Applicant, please complete) Print Name: Date: Current Address: Social Security No. : Date of Birth: Sex: Driver License No.: State: Applicant s Signature: Page 1 of 2

6 DISCLOSURE AND RELEASE OF INFORMATION AUTHORIZATION I authorize Southern Landscape Group, Inc. to retrieve information from all personnel, educational institutions, government agencies, companies, corporations, credit reporting agencies, law enforcement agencies at the federal, state or county level, relating to my past activities, to supply any and all information concerning my background. The information received may include, but is not limited to, academic, residential, achievement, job performance, attendance, litigation, personal history, credit reports, driving records, and criminal history records. I understand that this information may be transmitted electronically and authorize such transmission. If currently employed: My current employer may be contacted. YES NO N/A Post Hire Only Applicant's Initials I understand that a Consumer Report or Investigative Consumer Report ("Consumer Report") may be prepared summarizing this information. If my prior employers and/or references are contacted, the report may include information obtained through personal interviews regarding my character, general reputation, personal characteristics and/or mode of living. I may request a copy of any report that is prepared regarding me and may also request the nature and substance of all information about me contained in the files of the consumerreporting agency. I understand that I have the right to inspect those files with reasonable notice during regular business hours and that I may be accompanied by one other person. The consumer-reporting agency is required to provide someone to explain the contents of my file. If so, would you like a copy of any Consumer Report prepared on you? YES NO I hereby certify that all the statements and answers set forth on the application form and/or my resume are true and complete to the best of my knowledge, and I understand that if subsequent to employment any such statements and/or answers are found false or that information has been omitted, such false statements or omissions will be just cause for the termination of my employment. Further, I understand that by requesting this information, no promise of employment is being made. / am willing that a photocopy of this authorization be accepted with the same authority as the original; and that if employed by the above-named company (except if employed in the state of California), this authorization will remain in effect throughout such employment. Applicant s Signature Date NOTE: The following information is needed to conduct your background investigation and prepare a Consumer Report. This information IS NOT considered part of your application; it is used only for identification purposes. Other than its use in conducting your background investigation and its inclusion in the report, this information will not be shared unless required by law or you so authorize. Page 2 of 2 FORM: ACC-501 ISSUED: 11/26/2013 DEPARTMENT: HUMAN RESOURCES REV 0