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Applicant Information

Full Name *

Email Address *

Phone *

Address

City, State, Zip

Position Applied For

Salary Desired

Date Available

Have you ever worked for this company?

Yes

No

Criminal Record

Have you ever been convicted of a felony?

Yes

No

Education

High School

Address

From

To

Did you graduate?

Yes

No

Diploma

College

Address

From

To

Did you graduate?

Yes

No

Degree

Other School

Address

From

To

Did you graduate?

Yes

No

Degree

References

Full Name

Company

Relationship

Address

Phone

Full Name

Company

Relationship

Address

Phone

Full Name

Company

Relationship

Address

Phone

Previous Employment

Company

Phone Number

Supervisor

Job Title

Address

From

Starting Salary

To

Final Salary

Responsibilities

Reason for Leaving

May we contact your previous supervisor for a reference?

Yes

No

Company

Phone Number

Supervisor

Job Title

Address

From

Starting Salary

To

Final Salary

Responsibilities

Reason for Leaving

May we contact your previous supervisor for a reference?

Yes

No

Company

Phone Number

Supervisor

Job Title

Address

From

Starting Salary

To

Final Salary

Responsibilities

Reason for Leaving

May we contact your previous supervisor for a reference?

Yes

No

Military Service

Branch

From

To

Rank at Discharge

Type of Discharge

If other than honorable, explain.

Disclaimer

I certify that my answers are true and complete to the best of my knowledge.

If this application leads to employment, I understand that false or misleading information in my
application or interview may result in my release.

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Email

Plants Unlimited
629 Commercial Street (Rt. 1)
(PO Box 374)
Rockport, ME 04856

(207) 594-7754
info@plants-unlimited.com

Hours:

8:30am - 5:00pm

Seven Days a week!

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