Landry's Landscape, Inc | Baton Rouge, Louisiana

APPLICATION FOR EMPLOYMENT

General Information
	First Name*
	Last Name*
	Middle*
	Address*
	City*
	State*
	Zip Code*
	Email Address*
	Home Phone*
	Cell Phone

Education and Training
Select the highest grade in years completed:
8 9 10 11 12	High School Level
1 2 3 4	University Level
1 2 3	Graduate School Level

Please provide the following information about your education (including highschool, trade, and vocational universities).
A.
	School Name
	School Address
	Date of Addmission
	Date of Completion
	Degrees/ Diplomas
B.
	School Name
	School Address
	Date of Addmission
	Date of Completion
	Degrees/ Diplomas

Special Qualifications or Cerfications; (include name of institution, start and completion date of program, date achieved):

Industry/Business Training. (Include business and industry seminars and workshops:
	Course
	Date Taken
	Institution Providing Training
What did you learn?
How did the course help you?
	Where did you hear about us? (newspaper, friend, etc.)
yes no - If yes, when	Have you worked with us before?
yes no	Do you have a valid drivers licence?
yes no	Do you have a car?
yes no	Is your current drivers licence clean?
Please describe your current state of health
	Position 1st applied for
	Expected Salary
List any friends or relatives working for us:
Present Employment History
	Present Employer
	Present Employer's Address
	Present Employer's Telephone Number
	Present Supervisor
	Present Employer's - Type of Business
	Present Job Title
Present Job Duties:
Why are you leaving?
What would your present employer say about you?
Past Employment History
(list most recent past employment)
	Past Employer
	Past Employer's Address
	Past Employer's Telephone Number
	Past Supervisor
	Past Employer's - Type of Business
	Past Job Title
Past Job Duties:
	When did you start (m/y)?
	When did you leave(m/y)?
Why did you leave?
What would your past employer say about you?

By selecting "YES" below, I:
A. Authorize the verification of the above information, and any other necessary inquires that may be needed to determine my suitability for employment.
B. Affirm the above information is true.
YES

DATE