Employment Application

"Experience A New Level of Professionalism"

Integrity and Trust - Do the Right Thing, Nothing Less
People + Growth & Development = Opportunity
Cultivate Every Resource. Pull Weeds Immediately.
We achieve the best results through the combined efforts of each individual.
We Care - Period

We are an equal opportunity employer

Basic Information

Please fill out this form in its entirety

First Name:

Last Name:

Middle Initial:

Your Email Address:

Your Phone Number:

Street Address:

City:

State:

Zip Code:

How did you hear about us:

News Paper Craig's List

Friend:

Other:

If you have ever filed an application with us before, please specify when:

If you have ever been an employee with us before, please specify when:

What type of work for which you wish to be considered for:

Which position are you applying for:

Full Time Part Time

Other:

If hired, when would you be available:

What are your salary requirements:

Employment History (Most recent or current employer)

Employer:

Name of Supervisor:

Employer Address:

Employer City:

Employer Phone:

Employment Period:

From To

Type of Work Performed:

Starting Salary:

Present or Last Salary:

Reason for leaving:

Employment History (Employer 2)

Employer:

Name of Supervisor:

Employer Address:

Employer City:

Employer Phone:

Employment Period:

From To

Type of Work Performed:

Starting Salary:

Present or Last Salary:

Reason for leaving:

Employment History (Employer 3)

Employer:

Name of Supervisor:

Employer Address:

Employer City:

Employer Phone:

Employment Period:

From To

Type of Work Performed:

Starting Salary:

Present or Last Salary:

Reason for leaving:

Education: High School

Name of High School:

High School City:

High School State:

Years completed:

1 year 2 years 3 years 4 years

Aquired Diploma:

Yes No

Education: College

Name of College:

College City:

College State:

List Major Courses:

Years completed:

1 year 2 years 3 years 4 years

Aquired Degree:

Associates Bachelors

Education: Business or Trade

Business or Trade School:

Business or Trade School City:

Business or Trade School State:

List Major Courses:

Months Attended:

Aquired Diploma/Degree/Certificate:

Diploma Degree Certificate None

Military Experience

Dates of Service:

From To

Rank:

If you served in the US Armed Forces, briefly describe the skills you acquired:

Hobbies & Other Interests

Please tell us about your hobbies or other interests:

Personal Information

Are you legally authorized to work in the U.S:

Yes No

Special Note: You will be required to furnish documents to verify your eligibility for employment in accordance with the Immigration Reform and Control Act and your employment is contingent upon furnishing such documents.

Are you at least 18 years of age:

Yes No

If you are under 18 years of age, can you provide required proof of your eligibility to work:

Yes No

Have you ever been convicted of a crime or are there any pending charges against you:

Yes No

If yes, please describe:

Special Note: A conviction does not automatically bar you from employment) You are not required to disclose the existence of any arrest, criminal charge or conviction, the records of which have been erased pursuant to Connecticut General Statutes § 46b-146, 54-76o, or 54-142a. If your criminal records have been erased pursuant to one of these statutes, you may swear under oath that you have never been arrested. Criminal records that may be erased are records pertaining to a finding of delinquency or that a child was a member of a family with service needs (C.G.S. § 46b-146), an adjudication as a youthful offender (C.G.S. § 54-76o), a criminal charge that has been dismissed or nolled, a criminal charge for which the person has been found not guilty or a conviction for which the person received an absolute pardon (C.G.S. § 54-142a).

Do you have any other skills you wish to mention:

Are you presently employed:

Yes No

If you are presently employed, may we contact your present employer:

Yes No

Indicate any Foreign Languages you can Speak, Read and/or Write

Language 1: Speak Read Write

Language 2: Speak Read Write

Language 3: Speak Read Write

Licensing & Training

Do you currently hold any of the following licenses / training certifications?

Have CDL License:

Yes No

State: Expiration date:

Have Osha 10 License:

Yes No

State: Expiration date:

Have Osha 30 License:

Yes No

State: Expiration date:

Have Hoisting License:

Yes No

State: Expiration date:

CT Applicator's License:

Expiration date:

CT Supervisory License:

Expiration date:

MA Applicator's License:

Expiration date:

MA Supervisory License:

Expiration date:

J-3 License:

Expiration date:

J-4 License:

Expiration date:

Do you have any other licensing that you would like to list:

Describe any specialized training, apprenticeships, skills:

Equipment Experience

Please indicate wheter on not you have used the following equipment

Push Mower:

Mfg. of Equipment:

Belt Driven Mower:

Mfg. of Equipment:

Hydro Mower:

Mfg. of Equipment:

Zero Turn Mower:

Mfg. of Equipment:

Hustler:

Mfg. of Equipment:

String Trimmer:

Mfg. of Equipment:

Stick Edger:

Mfg. of Equipment:

Back Pack Blower:

Mfg. of Equipment:

Push Blower:

Mfg. of Equipment:

Trenchmaster:

Mfg. of Equipment:

Powerbroom:

Mfg. of Equipment:

Smithco Lawn Sweeper:

Mfg. of Equipment:

Tennant Street Sweeper:

Mfg. of Equipment:

Leafloader:

Mfg. of Equipment:

Gas Hedge Trimmer:

Mfg. of Equipment:

Electric Hedge Trimmer:

Mfg. of Equipment:

Extension Hedge Trimmer:

Mfg. of Equipment:

Chainsaw:

Mfg. of Equipment:

Aerator:

Mfg. of Equipment:

Rototiller:

Mfg. of Equipment:

Compactor:

Mfg. of Equipment:

Auger, Hand:

Mfg. of Equipment:

Skidsteer With Bucket:

Mfg. of Equipment:

Skidsteer With Forks:

Mfg. of Equipment:

Kubota:

Mfg. of Equipment:

Truck with Snowplow:

Mfg. of Equipment:

Truck with Sander:

Mfg. of Equipment:

Snowblower:

Mfg. of Equipment:

Hand Held Spreader:

Mfg. of Equipment:

Walk Behind Spreader:

Mfg. of Equipment:

Ride-On Spreader:

Mfg. of Equipment:

Tractor with Spreader:

Mfg. of Equipment:

Back Back Sprayer:

Mfg. of Equipment:

Liquid Tankers:

Mfg. of Equipment:

Please list any other equipment experience here:

References (please provide 3)

First Reference

Full Name:

Occupation:

Address:

City:

State:

Zipcode:

Phone Number:

Second Reference

Full Name:

Occupation:

Address:

City:

State:

Zipcode:

Phone Number:

Third Reference

Full Name:

Occupation:

Address:

City:

State:

Zipcode:

Phone Number:

Employment Application Agreement

I certify that the answers given by me to the foregoing questions and statements are true and correct to the best of my knowledge without consequential omissions of any kind.

I agree that the Company shall not be held liable in any respect if my employment is rejected or subsequently terminated because of false statements, answers or omissions made by me in this application.

I understand that any misleading or incorrect statements may render this application void, and if employed, may lead to employment termination.

I understand that a medical examination based on the requirements of the position for which I am being considered may be required, and drug testing may be included as part of the regular pre-employment physical.

I also voluntarily and knowingly authorize the companies, schools or persons named above to give any information requested regarding my former employment, character and qualifications.

I hereby voluntarily and knowingly fully release and discharge, absolve, indemnify, and hold harmless said companies, schools or persons from any and all liability for any damages for issuing this information, except for the malicious and willful disclosure of derogatory facts concerning my employment made for the express purpose of preventing me from obtaining employment, which the party disclosing such facts knows to be untrue.

In consideration of my employment, I agree to conform to the rules and regulations of this organization. I understand that employment with Beebe Landscaping Services, Inc. is at-will, meaning that my employment and compensation can be terminated with or without cause and with or without notice, at any time, at the option of either my employer or myself. While employment policies or procedures may change from time to time, only a written agreement signed by the company's president can change the employee's at-will status.

I agree to the terms of this employment application

Word Verification:

Letters are not case sensitive

Beebe Landscape Services

Employment Application

"Experience A New Level of Professionalism"

We are an equal opportunity employer