PERSONAL INFORMATION

 
Name(Last Name First) Email Social Security No
Present Address APT No City STATE ZIP
PHONE DATE OF BIRTH SINGLE / MARRIED NO. OF DEPENDANTS

DESIRED EMPLOYMENT

POSITION date you can start salary desired
ARE YOU EMPLOYED NOW? YES NO   
MAY WE CONTACT YOUR PRESENT EMPLOYER YES NO   
ever applied to this company before YES NO   
ever worked for RLC before  YES NO  

EDUCATION

School level name and location of school no.of years attended did you graduate
High School
college
trade business or correspondence school

GENERAL

subject of special study of research work
special training
special skills
emergency contact
phone
wife name / phone
What experience level do you have
Were you referred by a current employee
Do you have valid driver’s license
Do you have transportation to and from work
Have you worked at this company before

AUTHORIZATION TO OBTAIN MOTOR VEHICLE RECORDS POTENTIAL EMPLOYEE SIGNATURE REQUIRED

Date
To Potential Employee:

I am aware that consumer and motor vehicle reports may be obtained as a part of RLC Landscaping Company's evaluation of my job application and/or employment. The reports may be procured by RLC Landscaping Company or its insurance company representative(s), and may be include personal information obtained from state motor vehicle department, my driving record, an assessment of my insurability for the insurace program, or other consumer reports.

By signing this letter, I hereby provide my authorization for RLC Landscaping company or their insurance company representive(s) to procure such information and reports, as well as additional reports about me from time to time as deemed appropriate, to evaluate my insurability or for other permissible purposes.

sincerely,
Signature of Applicant/Employee
Name as it appears on Driver License
Driver License Number/State of Issuance
Date of Birth