Beier's Greenhouse & Quality Nursery
EMPLOYMENT APPLICATION

APPLICATION INSTRUCTIONS:
1. NO PHONE CALLS. Submit only by MAIL OR IN PERSON.
2. Complete all pages of this form completely and accurately.
3. Please thoroughly read all statements contained in this Application Form.
APPLICANT NOTE:
REQUIREMENTS FOR THIS JOB INCLUDE SOME EVENING AND WEEKEND AVAILABILTY FOR WORK. This application form is intended for use in evaluating your qualifications for employment. This is not an employment contract. False or misleading statements during the interview and/or on this form are grounds for terminating the application process or are grounds for termination of employment.
EEO STATEMENT
We are an Equal Employment Opportunity employer and do not discriminate in our hiring or employment practices. All qualified applicants will receive consideration without regard to race, color, creed, religion, national origin, age, disability, sex, or any other characteristic protected by State or Federal law.

APPLICANT INFORMATION: Today’s Date: _____________
Name: _____________________________________________________________________________
First Middle Last

Home Phone: _______________ Work Phone ______________ Cell Phone___________
Social Security #________________ Are you 16 or over? ___________________
Current Address: _______________________________________________________________

Do You Know anyone currently employed here (excluding spouse)?
Who_____________________________Relation_______________________________

Are you Currently Employed?________Where?_____________________Hours?_____________
Supervisors Name:_________________________May we contact?_______________________

DAYS & HOURS AVAILABLE: including Sat. & Sun. Available Starting:______Until:______
MON TUES WED THUR FRI SAT SUN
__to__ __to__ __to__ __to__ __to__ __to__ __to

FULL DAYS ___YES ___ SOME___ NEVER ___ Full Time____ Part Time_____
NIGHTS: ___YES ___SOME ___NEVER ___ Most Hours want to work?____
WEEKENDS: ___YES ___SOME ___NEVER ___ Least Hours want to work?____
ANYTIME: ___YES ___SOME ___NEVER___ Can you come in to 1-2 hours to notice?___

EDUCATION
Name City/State Degree Earned
High School
College
Other

PREVIOUS EMPLOYMENT

COMPANY NAME:_______________________FROM: Mo.____Yr.____ TO: Mo._____Yr._____
ADDRESS:____________________________CITY:____________STATE:______ZIP:________
PHONE #:_______________SUPERVISOR:____________MAY WE CONTACT?:____________
SALARY? _________JOB DUTIES? ___________________REASON FOR LEAVING? _______

COMPANY NAME: _______________________FROM: Mo.____Yr.____ TO: Mo._____Yr._____
ADDRESS: ____________________________CITY:____________STATE:______ZIP:________
PHONE #:_______________SUPERVISOR:____________MAY WE CONTACT? ____________
SALARY? _________JOB DUTIES? ___________________REASON FOR LEAVING? _______

PREFERENCES TO TYPE OF WORK IF HIRED

GENERAL: ____CASHIER:____ STOCKING: ____WATERING:____POTTING PLANTS: _____ FLORAL DESIGN: ______ LANDSCAPE/NURSERY: _____

DO YOU HAVE ANY EXPERIENCE IN THE FOLLOWING?

OPERATING CASH REGISTER: _____________WORKING WITH PLANTS:________________
IDENTIFY PLANTS:_______________________GARDENING:___________________________
FLORAL DESIIGNS_______________________GIFTS & CRAFTS: _______________________ LANDSCAPING: ________________________ LAWN & GARDENING___________________
WORKING IN A GREENHOUSE: ___________WORKING IN A NURSERY:_________________

OTHER PREVIOUS JOB EXPERIENCE THAT MIGHT BE HELPFUL IF YOU ARE HIRED?

REFERENCES:
Include only individuals familiar with your work capabilities. Do not include relatives.
NAME - ADDRESS - PHONE - YEARS KNOWN - RELATIONSHIP

1.

2.

3.

CERTIFICATION:

I certify the answers given to me by the foregoing questions and any statements made by me are complete and true to the best of my knowledge and belief. I understand that any false information, omissions, or misrepresentations of facts regarding information called for in this application may result in rejection of my application, or discharge at any time during my employment. If I am hired, my employment shall be “at-will”, and that either the Company or I can choose to terminate the employment relationship for any reason, or no reason at all, without notice.

Signed ___________________________________________________ Dated ______________

Mail Completed Application to:
Beier's Greenhouse
Department WSE
2707 Midway Lane
Grand Rapids, MN 55744