Date *

MM

DD

YYYY

Name *

First Name

Last Name

Phone *

(###)

###

####

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Employee Status *

I'm only interested in part-time employment (specify below in "Availability Notes")

I'm only interested in full-time employment

I'm open to working part or full time, as needed

I'm open to working over-time, as needed

Work Availability *

* note - normal work hours, in season, are usually around 8:30am-5:00pm (Monday-Friday) Check all that apply

I'm ready to start whenever

I need to turn in my two-weeks notice after we make a decision

I will be available at a date I will list below in "Availability Notes"

Most days I would be available to begin work at 7:30am and/or work until 6:00pm, if needed

Do you have a high school diploma or equivalency? *

Yes

No

Are you presently employed? *

Yes

No

May we contact any of the professional and personal references you listed below?

Yes

No

Supervisor Name

First Name

Last Name

Phone #

(###)

###

####

Supervisor Name

First Name

Last Name

Phone

(###)

###

####

Supervisor Name

First Name

Last Name

Phone

(###)

###

####

#1 - PERSONAL REFERENCE

First Name

Last Name

Phone

(###)

###

####

Equipment Experience

I have experience and am comfortable with the following equipment. Check all that apply:

Basic Hand Tools

Axe

Wheel Barrow

Driving a one-ton truck

Driving a Medium Duty Truck

Driving with a Trailer

Backing with a Trailer

Chain Saw

Mini Skid Steer

Skid Steer

Mini Excavator

Level

Tiller

Sod Cutter

Physical Capability

Which items are you physically capable of and willing to do? Check all that apply:

Working outside all day in variable weather conditions

Working on a slope for extended periods (4+ hours)

Bending

Twisting

Small stump removal including cutting tree roots out with an axe

Using a sledge hammer to break concrete or similar

Repeated Lifting of 50+ lbs

Repeated Lifting of 20+ lbs

Have you ever been employed with this company before? *

Yes

No

If hired, can you provide proof of United States citizenship or proof of your legal right to work in this country? *

Yes

No

Do you have a legal driver's license? *

Yes

No

If hired, do you have a reliable method of transportation to work? *

* note- we work in locations all over Madison and these locations often vary from day to day.

Yes

No

Have you, in the last seven (7) years, been convicted of Driving Under the Influence (DUI)? *

Yes

No

Have you ever been convicted of, or pled guilty to a crime or felony? *

*Note - a conviction may be considered as it relates to the job in question, but a conviction won’t necessarily disqualify an applicant from consideration. This is also not a request for your consent to perform a private, criminal background check. We will send consent requests separately, to any final applicants.

Yes

No