Lighted Gardens - Job Applications

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Job Position Applying for:

Salary Requirments: Per Hour

Who referred you this company?

Have you ever applied before: When?

Are you at least 18 years old? Yes
No

Previous Employer 1:

Job Duties At Employer 1

Dates of Employment 1

Reason for leaving employer 1

May we contact employer 1? How?

Previous Employer 2:

Job Duties at Employer 2

Dates of Employment 2

Reason for leaving employer 2

May we contact employer 2? How?

College Education

High School Education

What is your availability?

When can you start?

I certify that fax containing in this application are true and complete to the best of my knowledge and understanding that, if employed: falsified statements on this application shall be grounds for dismissal. I authorize investigation of all statements contained herein and the employers listed to give you and any all information concerning my previous employment and any pertinent information that may have, personal or otherwise, and release the company from all liability for any damage that may result from utilization of such information. This waiver does not permit the release or use of disability – related or medical information in a manner prohibited by the Americans with disability (ADA) in other relevant federal and state laws Yes

Today's Date

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After submission, please contact us by phone to insure your application is recieved. 260-622-4026

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