GGandG - Employment Application

G G & G Garbage Application Form

Applicants may be tested for illegal drugs.

Last Name*

First Name*

Middle Name

Maiden Name

Street Address*

City*

State*

ZIP*

How long at this address?*

Social Security Number*

Date of birth*

Phone*

Email*

If the applicant is younger than 18 years of age, please list age

What position is the applicant applying for?*

What salary does the applicant desire?*

(Be specific)

Days / Hours available to work

Which days are you available to work?*

Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday

Monday*

What time can you start?

:

Monday*

What time can you end?

:

Tuesday*

What time can you start?

:

Tuesday*

What time can you end?

:

Wednesday*

What time can you start?

:

Wednesday*

What time can you end?

:

Thursday*

What time can you start?

:

Thursday*

What time can you end?

:

Friday*

What time can you start?

:

Friday*

What time can you end?

:

Saturday*

What time can you start?

:

Saturday*

What time can you end?

:

Sunday*

What time can you start?

:

Sunday*

What time can you end?

:

How many hours can the applicant work weekly?*

Can the applicant work nights?*

What type of employment does the applicant desire?*

Full-Time Only
Part-Time Only
Full-Time or Part-Time

When will the applicant be able to begin working?*

Education

Please check all that apply

The applicant has completed or has completed some High School
The applicant has completed or has completed some College
The applicant has completed or has completed some Bus or Trade School
The applicant has completed or has completed some Professional School

Name of High School?*

Location of High School?*

Number of years completed at High School?*

Major / Degree while in High School?

Ex: High School Diploma, any majors that the applicant were a part of if in enrolled in an academy, etc...

Name of College?*

Location of College?*

Number of years completed at College?*

Major / Degree while in College?

Name of Bus. or Trade School?*

Location of Bus. or Trade School?*

Number of years completed at Bus. or Trade School?*

Major / Degree while in Bus. or Trade School?

Name of Professional School*

Location of Professional School*

Number of years completed at Professional School*

Major / Degree while in Professional School?*

Criminal Record

Has the applicant ever been convicted of a crime?*

No
Yes

If yes, explain number of conviction(s), nature of offense(s) leading to conviction(s), how recently such offense(s) was/were committed, sentence(s) imposed, and type(s) of rehabilitation.*

Driver's License

Does the applicant have a driver's license?*

Yes
No

What is the applicant's means of transportation to work?*

Driver's license number?*

Check the boxes that the applicant is in possession of*

Operator's License
Commercial (CDL) License
Chauffer License

State of Issue*

Expiration Date*

Has the applicant had any accidents during the past three years?*

Yes
No

How many accidents?*

Has the applicant had any moving violations during the past three years?*

Yes
No

How many moving violations?*

Office Only

Typing*

Yes
No

WPM*

Words per minute

Personal Computer*

Yes
No

Check all that apply*

PC
Mac

10-key*

Yes
No

Word Processing*

Yes
No

WPM*

Words per minute

Other

Skills

References

Please list two references other than relatives or previous employers.

Reference #1

Name*

Position*

Company*

Street Address*

City*

State*

ZIP*

Phone*

Reference #2

Name*

Position*

Company*

Street Address*

City*

State*

ZIP*

Phone*

Qualifications

An application form sometimes makes it difficult for an individual to adequately summarize a complete background. Use the space below to summarize any additional information necessary to describe your full qualifications for the specific position for which you are applying.

Insert additional qualifications here

Military

Has the applicant ever been in the armed forces?*

Yes
No

Is the applicant currently a member of the National Guard?*

Yes
No

Specialty*

Date entered*

Discharge date*

Work Experience

Please list your work experience for the past 5 years beginning with your most recent job held. If you were self-employed, give firm name. Attach additional sheets if necessary.

How many jobs has the applicant had in the past 5 years?*

Job #1

Name of Employer*

Street Address*

City*

State*

ZIP*

Phone*

Name of last supervisor*

When did the applicant begin working here?*

When did the applicant stop working here?*

What was the applicant's pay/salary when they began working here?*

Ex: "$10.00/hr" or "$30,000.00/yr"

What was the applicant's pay/salary when they stopped working here?*

Ex: "$10.00/hr" or "$30,000.00/yr"

What was the applicant's last job title?*

Reason for leaving?*

Be specific.

List the jobs you held, duties performed, skills used or learned, advancements or promotions received while you worked at this company.*

Job #2

Name of Employer*

Street Address*

City*

State*

ZIP*

Phone*

Name of last supervisor*

When did the applicant begin working here?*

When did the applicant stop working here?*

What was the applicant's pay/salary when they began working here?*

Ex: "$10.00/hr" or "$30,000.00/yr"

What was the applicant's pay/salary when they stopped working here?*

Ex: "$10.00/hr" or "$30,000.00/yr"

What was the applicant's last job title?*

Reason for leaving?*

Be specific.

List the jobs you held, duties performed, skills used or learned, advancements or promotions received while you worked at this company.*

Job #3

Name of Employer*

Street Address*

City*

State*

ZIP*

Phone*

Name of last supervisor*

When did the applicant begin working here?*

When did the applicant stop working here?*

What was the applicant's pay/salary when they began working here?*

Ex: "$10.00/hr" or "$30,000.00/yr"

What was the applicant's pay/salary when they stopped working here?*

Ex: "$10.00/hr" or "$30,000.00/yr"

What was the applicant's last job title?*

Reason for leaving?*

Be specific.

List the jobs you held, duties performed, skills used or learned, advancements or promotions received while you worked at this company.*

Job #4

Name of Employer*

Street Address*

City*

State*

ZIP*

Phone*

Name of last supervisor*

When did the applicant begin working here?*

When did the applicant stop working here?*

What was the applicant's pay/salary when they began working here?*

Ex: "$10.00/hr" or "$30,000.00/yr"

What was the applicant's pay/salary when they stopped working here?*

Ex: "$10.00/hr" or "$30,000.00/yr"

What was the applicant's last job title?*

Reason for leaving?*

Be specific.

List the jobs you held, duties performed, skills used or learned, advancements or promotions received while you worked at this company.*

May we contact the applicant's present employer?*

Yes
No

Did the applicant complete this application themselves?*

Yes
No

If not, who did?*