Under The Sun Garden Centers

Location Desired
Full Name
Last Name
First Name
Middle Name
Present Address
City
State
Zip
Phone
Permanent Address
City
State
Zip
Phone
Cell Phone
Email Address
Social Security #



Position Desired
Schedule Desired
Full Time Part Time
Shift Work Temporary
Preferred Work Schedule
Date You Can Start
Salary Range Desired
Able to Work Overtime
Yes No



Applied to Us Before? Yes No If yes, give date:  
Employed by Us Before? Yes No If yes, give date:  
Are You Employed Now? Yes No
Are You 18+ years-old? Yes No (Proof may be required)
Can work legally in this country? Yes No (Proof may be required)



How Were You Referred?
Drivers License #
State
Commercial
Yes No
Emergency Contact Name
Address
Phone



Do not answer this question unless you have been informed of the requirements of this position. Are you capable of performing the essential functions of this position as they have been outlined to you? Yes No

If not, what function(s) can you NOT perform and what accommodation(s) would be required in order for you to perform these function(s)?



Education Name/Location Years Completed Year Graduated Degree/Diploma
High School
College
Trade/Business
Other



List any special honors, certificates, awards or training you have received
Note any additional information that may help us in considering your application
What has motivated you to submit an application with Under The Sun?
In what way would Under The Sun benefit by having you as an employee?


Personal References (Not Related to You)
Reference Address Phone Business Years Known


Employment Experience - start with your present or last job

Job 1
Start Date
End Date
May We Contact
Yes No
Employer
Supervisor
Address
Phone
Reason for Leaving
Start Salary
End Salary

Job 2
Start Date
End Date
May We Contact
Yes No
Employer
Supervisor
Address
Phone
Reason for Leaving
Start Salary
End Salary

Job 3
Start Date
End Date
May We Contact
Yes No
Employer
Supervisor
Address
Phone
Reason for Leaving
Start Salary
End Salary

Job 4
Start Date
End Date
May We Contact
Yes No
Employer
Supervisor
Address
Phone
Reason for Leaving
Start Salary
End Salary



Have you been convicted of a felony or misdemeanor? Yes No
(Convictions are not a bar to employment in all cases. Each situation is evaluated individually.)

If yes, please describe:



I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that if employed, falsified statements on this application or interview may be grounds for dismissal.

I authorize investigation of all statements contained herein and the references listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release all parties from all liablility from any damage that may result from furnishing same to you.

I understand and agree that, if hired, my employment will be 'at will', without any definite period of time, and may be terminated at any time, with or without cause and with or without prior notice, regardless of the date of payment of my wages or salary.

I understand that as a condition of employment, I may be required to undergo a medical examination and substance test.

Date
Signature