Employment Application

Application for Employment (Active for 30 days or until job is filled, whichever is earlier)

First Name (*)

Please let us know your first name.
Last Name (*)

Please let us know your Last Name
Address (*)

Please let us know your address
City (*)

Please let us know your City
State (*)

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Zip Code (*)

Please let us know your Zip Code
Telephone (*)

Please let us know your Phone Number
Does your present employer know of your plans to change employment? (*)

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Social Security #

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Gregory Pest Control, Inc. is an Equal Opportunity Employer


Applications are received and employees are hired without regard to race, creed, color, sex, religion, age, national origin, disability, and veteran's status, or any other protected class under state, county, or local regulations. Testing of job related skills and for the presence of drugs in your body may be required prior to employment. The receipt of this application does not mean that job openings exist and does not obligate Gregory Pest Control, Inc. in any way. We appreciate your interest in our organization.


All Questions Must Be Answered. State "N/A" If Question is Not Applicable.


Personal Information

Date of Application (*)

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Position(s) Applied For (*)

Please let us know the Position(s) you're applying for
Salary Expectation (*)

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On what date will you be available for work? (*)

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Are you available to work? (*)

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Are you employed now? (*)

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Why do you desire to make a change?

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Are you on layoff and subject to recall? (*)

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Have you ever been discharged or have you ever been requested to resign from a position? (*)

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If yes, please explain

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Would you have steady transportation to work? (*)

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Can you travel overnight if a job requires it? (*)

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Have you ever been refused Bond? (*)

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If yes, please explain

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Have you ever been convicted or received a sentence for a crime(s) other than a minor traffic violation? (Answering "yes" is not an automatic bar from employment) (*)

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If yes, state offense, date, court and place where offense occured

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Are you legally eligible to work in the United States? (Proof of immigration/citizenship status and identity is required upon employment) (*)

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Do you hold a valid driver's license? (*)

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List state

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Have you been convicted of any moving violation in the past 3 years? (*)

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If yes, give dates and explain

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List 3 three things that are important to you in a work environment (*)

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List 3 characteristics that best describe you (*)

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Why do you want to work for Gregory Pest Control? (*)

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Full Employment History


Please complete your job history with your most recent job first. Please explain any employment gaps at the bottom of this page.

Employer

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Address (Street, City, Zip)

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Job Title

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Supervisor

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Reason For Leaving

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Dates Employed (From Mo/Yr / To Mo/Yr)

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Phone

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Hourly Rate/Salary (Starting & Final)

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Work Performed and Job Responsibilities

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Employer

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Address (Street, City, Zip)

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Job Title

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Supervisor

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Reason For Leaving

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Dates Employed (From Mo/Yr / To Mo/Yr)

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Phone

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Hourly Rate/Salary (Starting & Final)

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Work Performed and Job Responsibilities

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Employer

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Address (Street, City, Zip)

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Job Title

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Supervisor

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Reason For Leaving

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Dates Employed (From Mo/Yr / To Mo/Yr)

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Phone

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Hourly Rate/Salary (Starting & Final)

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Work Performed and Job Responsibilities

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Special Skills and Qualifications

Summarize special training, skills and qualifications acquired from employment or other experiences

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List professional, trade, business, or civic activities and offices held

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Educational Information

High School (Name & Location)

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Years Completed

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Did you graduate?

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Trade School (Name & Location)

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Years Completed

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Did you graduate?

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Course of Study

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College (Name & Location)

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Years Completed

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Did you graduate?

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Major & Degree

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Graduate School (Name & Location)

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Did you graduate?

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Major & Degree

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Honors received

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Military Service

Branch of Service

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Rank at Discharge

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References


List the names of three persons not related to you who have known you for at least two years.

Name

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Address

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Phone

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Profession

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Years Known

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Name

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Address

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Phone

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Profession

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Years Known

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Name

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Address

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Phone

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Profession

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Years Known

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Applicant's Statement, Authorization, and General Release


By submitting this application, I hereby affirm that the information on this form is true and correct and that there are no omissions. I understand that false or misleading information, given either during this application process or after employment, may result in discharge. Additionally, I hereby authorize Gregory Pest Control, Inc. or its agent to obtain, and/or any entity or person providing information to furnish background information, verification, and records concerning me, including, but not limited to, employment, military, and educational information. Specifically, I authorize all of my current and former employers to provide reference information including my job performance, my work record and attendance, the reason(s) for my leaving, my eligibility for rehire, and my sustainability for the position I am now seeking. I encourage my current and former employers to provide complete responses to requests for information, including information which is believed to be true but not documented. I realize some information may be complementary and some may be critical. I promise I will not bring any legal claims or actions against my current or former employers due to their responses to job reference requests. I realize no one is required to give a reference, so I make this commitment to encourage the free exchange of reference information. I understand that all applicants are subject to pre-employment drug and alcohol screening and that detection of prohibited substances will revoke any conditional offer of employment. I also understand that if an offer of employment is tentatively made to me, it may be conditioned upon my successful completion of a medical examination. I understand and acknowledge that any employment with Gregory is "at will," that I have entered into my employment relationship with Gregory voluntarily, and that there is no specified length of employment in this relationship. Accordingly, either Gregory or I can terminate the relationship at will, with or without cause, at any time. I acknowledge that I have voluntarily provided the above information for employment screening purposes and have carefully read and understood this Statement, Authorization, and General Release.




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888-490-5832