Green With Envy Application for Employment

 

Green With Envy  is an Equal Opportunity Educational Institution and EEO/Affirmative Action Employer committed to excellence through diversity.  Employment offers are made on the basis of qualifications, and without regard to race, sex, religion, national or ethnic origin, disability, age, veteran status, or sexual orientation.

 

PLEASE TYPE OR PRINT.  Complete the entire application.  You may attach a resume, but you must still complete all questions; or your application will be deemed incomplete and may not be considered.  Please fill out each box (don't just indicate “See Resume.”)  Applications with missing or invalid job numbers will not be considered for any position. 

Position Applying For:

 

JOB #:        

Name  (Last, First, Middle):      

Other names under which you have attended school or been employed:

     

Street Address:      

City, State & Zip:      

Social Security Number:

     

Home Phone:

                            

Work Phone:

     

Other Phone:      

 

Are you eligible to work in the United States?

Yes     No

 

Are you 18 years of age or older?

 Yes     No

If NO,   what is your current age?

Do you have any state or felony convictions?

Yes      No

If YES, describe       

 

 

Have you ever been employed by

Green With Envy       

 Yes   No

If YES, dates of employment & reason for leaving:

     

 

 

Are you related to any current       Green With Envy employee?

Yes     No

If YES, their name & their relationship to you?      

If required for position, do you have a valid driver’s license?

 Yes    No

If YES, State of issuance, license #, and expiration date:      

How did you learn about this employment opportunity at      ?   Check all that apply:     Ad in newspaper

 Job Bulletin (Posting) /Walk-in Website       Dept. of Labor                                    Ad in magazine

 Referral by employee  Other: 

 

        EDUCATION

 

Name of School

 

City/State

Did you graduate?

If No, # of years left to graduate

If Yes,  date of Graduation

Degree received

 

Major

High School:      

 

     

Yes    No

     

     

     

     

GED:      

 

     

Yes    No

     

     

     

     

Other School:      

 

     

Yes    No

     

     

     

     

College:      

 

     

Yes    No

     

     

     

     

College:      

 

     

Yes    No

     

     

     

     

College:      

 

     

Yes    No

     

     

     

     

Other credentials/ licenses/ professional affiliations, etc., which are relevant to the job(s) for which you are applying.

     

 

 

      

       

 

 

SKILLS:  Please list technical skills, clerical skills, trade skills, etc., relevant to this position.  Include relevant computer systems and  software packages of which you have a working knowledge, and note your level of proficiency (basic, intermediate, expert)

     

 

 

 

 

     

 

WORK EXPERIENCE-Please detail your entire work history.  Begin with your current or most recent employer.  If you held multiple positions with the same organization, detail each position separately.  Attach additional sheets if necessary.  Omission of prior employment may be considered falsification of information. Please explain any gaps in employment.  Include full-time military or volunteer commitments.  PLEASE DO NOT complete this information with the notation “See Resume.”   

PLEASE NOTE:  Green With Envy reserves the right to contact all current and former employers for reference     information.

                               

Dates Employed (most recent position)

From:       To      

        

 

Full time        Part-time

 

If part-time, # hrs./wk:

Title:      

Starting Salary:     

 

Organization Name and Address:      

 

 

Final Salary:      

 

Supervisor’s Name, Title and Phone  #:      

 

 

Other Reference Name, Title and Phone #:      

 

 

Contact my current references:

 At any time

 Only if I am a finalist candidate

Primary duties:      

 

 

 

Reason for Leaving:      

Dates Employed (most recent position)

From:       To      

        

 

Full time        Part-time

 

If part-time, # hrs./wk:

Title:      

Starting Salary:     

 

Organization Name and Address:      

 

 

Final Salary:      

 

Supervisor’s Name, Title and Phone  #:      

 

 

Other Reference Name, Title and Phone #:      

 

 

Contact my current references:

 At any time

 Only if I am a finalist candidate

Primary duties:      

 

 

 

Reason for Leaving:      

 

 

   

 

 

 

 

 

 

 

 

 

 

 

 

  

 

 

  PLEASE READ CAREFULLY AND SIGN THAT YOU UNDERSTAND AND ACCEPT THIS INFORMATION.

  I certify that the information on this application and its supporting documents is accurate and complete.  I understand and agree that failure to fully

 complete the form, or misrepresentation or omission of facts,  represents grounds for elimination from consideration for employment, or termination after

 employment if discovered at a later date.  I authorize Green With Envy  to investigate, without liability, all statements contained in this

 application and supporting materials.  I authorize references and former employers, without liability, to make full response to any inquiries in connection

 with this application for employment. If requested, I agree to submit to a physical exam, criminal and credit background investigation, and/or screening

 for illegal substances upon conditional offer of employment.  I understand that this document is NOT an offer of employment, and that an offer of

 employment, if tendered, does NOT constitute a contract for continued guaranteed employment.  I understand that staff employees of  Green With Envy  

 serve at-will, and the employment relationship may be terminated at any time by either party, or any or no reason, other than a reason prohibited by law.

 If employed, I will be required to furnish proof of eligibility to work in the United States, to file a State security questionnaire and State loyalty oath, and to

 comply with company and departmental regulations. I understand that if employed on a temporary basis, I would be paid for hours worked only, and would

 be ineligible for benefits including paid time off.  If employed on a regular, benefits-eligible basis, I understand that I would be required to make mandatory

 contributions to the Green With Envy Retirement System or to an optional retirement program, if applicable.  I understand that any benefits I receive may be

 subject to change or discontinuation at any time without prior notice.  I understand that the first NINE MONTHS of regular employment represent a

 provisional period, during which I would not be eligible to apply for transfer or promotion and during which I may be  terminated without right of appeal.

 

      

Applicant Electronic Signature: ______________________________________          Date:  _______________                                                    

 

 

 

 

 

 

SUBMIT YOUR APPLICATION