Employment Application

*Last Name

*First Name

Middle Name

Maiden Name

*Street Address




*How long at this address?

*Social Security Number

*Phone Number


If under 18 please list age

Position applying for (please be specific)

Salary desired

Days available for work
 Monday Tuesday Wednesday Thursday Friday Saturday

Hours during each day you are available (example: Monday 7am - 7pm, Tuesday 8am -5pm, etc.)

How many hours can you work per week?

Can you work nights if asked to?
 Yes No

Employment Desired
 Full Time Only Part Time Only Full OR Part Time

How soon can you start work?

High School Attended

High School mailing address

Number of years completed

Did you graduate?
 Yes No

College Attended

College mailing address

Number of years completed

Major & Degree

Business or Trade School

Business or Trade School mailing address

Number of years completed

Major & Degree

Professional School

Professional School mailing address

Number of years complete

Major & Degree

Have you ever been convicted of crime?
 Yes No

If yes, explain number of conviction(s), nature of offense(s) leading to conviction(s), when did offense(s) occur, sentence(s) imposed, and type(s) of rehabilitation.

Do you have drivers license?
 Yes No

Drivers license number

State of issue

Type of license

Expiration date

Have you had any accidents in the past 3 years?
 Yes No

If so, how many?

Have you had any moving violations in the past 3 years?

 Yes No

If so, how many?

What is your means of transportation to work?

Please list 2 references other than relatives or previous employers

(1) Name




Phone Number

(2) Name




Phone Number

Have you ever service in the armed forces?
 Yes No

Are you now a member of the National Guard?
 Yes No


Date Entered

Discharge Date

Employment history for the past 5 years

List employer name, address, phone, supervisors name, employment dates, rate of pay, job title, duties performed, reason for leaving.

May we contact your present employer
 Yes No

Did you complete the application yourself
 Yes No

In exchange for the consideration of my job application by Dayton Lawn Mowing Inc. (hereinafter called “the Company”), I agree that:

Neither the acceptance of this application nor the subsequent entry into any type of employment relationship, either in the position applied for or any other position, and regardless of the contents of employee handbooks, personnel manuals, benefit plans, policy statements, and the like as they may exist from time to time, or other Company practices, shall serve to create an actual or implied contract of employment, or to confer any right to remain an employee of the Company, or otherwise to change in any respect the employment-at-will relationship between it and the undersigned, and that relationship cannot be altered except by a written instrument signed by the President /General Manager of the Company. Both the undersigned and the Company may end the employment relationship at any time, without specified notice or reason. If employed, I understand that the Company may unilaterally change or revise their benefits, policies and procedures and such changes may include reduction in benefits.

I authorize investigation of all statements contained in this application. I understand that the misrepresentation or omission of facts called for is cause for dismissal at any time without any previous notice. I hereby give the Company permission to contact schools, previous employers (unless otherwise indicated), references, and others, and hereby release the Company from any liability as a result of such contract.

I also understand that (1) the Company has a drug and alcohol policy that provides for pre-employment testing as well as testing after employment; (2) consent to and compliance with such policy is a condition of my employment; and (3) continued employment is based on the successful passing of testing under such policy. I further understand that continued employment may be based on the successful passing of job-related physical examinations.
I understand that, in connection with the routine processing of your employment application, the Company may request from a consumer reporting agency an investigative consumer report including information as to my credit records, character, general reputation, personal characteristics, and mode of living. Upon written request from me, the Company, will provide me with additional information concerning the nature and scope of any such report requested by it, as required by the Fair Credit Reporting Act.

I further understand that my employment with the Company shall be probationary for a period of sixty (60) days, and further that at any time during the probationary period or thereafter, my employment relation with the Company is terminable at will for any reason by either party.

 *I acknowledge I have read the above and agree

 *I acknowledge that my typed name below is considered to be the same my actual written signature

*Signature of applicant (type your full legal name)


This Company is an equal employment opportunity employer. We adhere to a policy of making employment decisions without regard to race, color, religion, sex, sexual orientation, national origin, citizenship, age or disability. We assure you that your opportunity for employment with this Company depends solely on your qualifications.

Thank you for completing this application form and for your interest in our business.