Application for Employment

    Your Personal Information

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    Your Emergency Contact

    In Case of an Emergency, I Authorize You to Contact:
    ALL QUESTIONS MUST BE ANSWERED STATE “N/A” IF QUESTION IS NOT APPLICABLE

    WE ARE AN EQUAL OPPORTUNITY EMPLOYER

    Applications are received and employees are hired without regard to race, sex (including pregnancy, sexual orientation, gender expression, and gender identity), national origin, color, religion, age, disability, genetic information, veteran’s status, citizenship status, or any other protected classes under state, local, or county regulations. The receipt of this application does not mean that job openings exist and does not obligate us in any way. We appreciate your interest in our organization.

    THIS IS A DRUG-FREE WORKPLACE

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    Tell Us About Yourself (You must answer every question on this application. If a question does not apply, put “N/A.” Please print.)

    • YESNO
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    • Full-timePart-timeTemporaryNightsWeekends
    • YESNO
    • YESNO
    • YESNO
    • YESNO
    • YESNO
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    • YESNO
    • YESNO
    • YESNO
    • YESNO
    • YESNO
    • YESNO

    Tell Us About Your Special Skills and Qualifications

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    Your Educational Background

    YESNO
    YESNO
    YESNO
    YESNO

    Tell Us About Your Driving Record (Necessary for positions that may require use of a personal or company vehicle for work)

    • YESNO
    • YESNO

    Tell Us About Any Records

    Have you ever been convicted of, received a sentence for, pled nolo contendere (no contest) to, been placed on probation, or fined by any judicial or quasi-judicial body for a crime, other than a minor traffic violation ?NOTE: Answering “yes” to this question is not an automatic bar to employment . Arrest records and juvenile, sealed, and expunged records should not be disclosed. Any other criminal record not disclosed by you may be considered falsification of this application, which may result in revocation of your employment offer or termination of your employment. Also, in accordance with any state or federal regulations, you may be required to provide copies of any criminal records.

    • YESNO

    Your Military Service

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    Tell Us About Your Past (Answering “yes” to any of these questions is not an automatic bar to employment.)

    • YESNO
    • YESNO

    Your Work History and Any Employment Gaps (Must be completed even when accompanied by resume) List most recent or current job first. You must include any gaps in employment, with a full explanation and dates for the gap. You must also provide a complete work history. If you need more space to provide a full work history, request additional work history pages.

    • Never Worked Before

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    Agreement and Release

    For the purpose of this agreement and release, Newton Nurseries. is referred to as “the company” or “you” in the following paragraphs.

    The facts set forth above in my application for employment are true and complete. I understand that false statements or omission of information on this application (even if discovered after employment) or any other employment form may lead to dismissal or denial of employment. If required, I agree to take a personality profile and to take, participate in, or submit to any other preemployment processes. I also agree to submit to any drug or alcohol testing prior to or after employment.

    In making this application for employment, I also understand that an investigative consumer report may be made whereby information is obtained through personal interviews with my neighbors, friends, or others with whom I am acquainted. I also acknowledge that the company may conduct a search for information about me that is in the public domain, including, but not limited to, information on social networking sites. In exchange for the consideration of my employment application by Newton Nurseries, I hereby release and forever discharge Newton Nurseries. (including its directors, officers, employees, and agents) and my past and/or present employers (including their directors, officers, employees, and agents) from any liabilities which may result from an investigation of my past and/or present employment or from the disclosure of such information. I authorize the use of any information in this application to verify my statements, and I authorize past employers, all references, and any other persons to answer all questions asked concerning my ability, character, reputation, and previous employment record.

    In making this application for employment, I also understand that an investigative consumer report may be made whereby information is obtained through personal interviews with my neighbors, friends, or others with whom I am acquainted. I also acknowledge that the company may conduct a search for information about me that is in the public domain, including, but not limited to, information on social networking sites. In exchange for the consideration of my employment application by Newton Nurseries, I hereby release and forever discharge Newton Nurseries. (including its directors, officers, employees, and agents) and my past and/or present employers (including their directors, officers, employees, and agents) from any liabilities which may result from an investigation of my past and/or present employment or from the disclosure of such information. I authorize the use of any information in this application to verify my statements, and I authorize past employers, all references, and any other persons to answer all questions asked concerning my ability, character, reputation, and previous employment record.

    In making this application for employment, I also understand that an investigative consumer report may be made whereby information is obtained through personal interviews with my neighbors, friends, or others with whom I am acquainted. I also acknowledge that the company may conduct a search for information about me that is in the public domain, including, but not limited to, information on social networking sites. In exchange for the consideration of my employment application by Newton Nurseries, I hereby release and forever discharge Newton Nurseries. (including its directors, officers, employees, and agents) and my past and/or present employers (including their directors, officers, employees, and agents) from any liabilities which may result from an investigation of my past and/or present employment or from the disclosure of such information. I authorize the use of any information in this application to verify my statements, and I authorize past employers, all references, and any other persons to answer all questions asked concerning my ability, character, reputation, and previous employment record.

    I understand that if my application is accepted and I am hired, employment at Newton Nurseries. is “employment at will." It is further understood that this at-will relationship may not be changed by any written document, verbal statements, or by conduct unless an authorized executive of Newton Nurseries. specifically acknowledges such change. I further understand that my at-will employment may be terminated at any time by me or by Newton Nurseries. and includes no guarantee, contract, or promise of employment for any specific length of time. I understand that the first 90 days of employment is a new-hire introductory period. Submission of this application does not imply that I will be hired.

    I have read, understand, and by my signature consent to these statements.

    State and/or federal regulations are subject to change at any time; therefore, the questions on this form are subject to exceptions and qualifications. The author does not bear responsibility for ensuring this form is up to date and compliant with state, federal, or local employment regulations. If in doubt, seek assistance from a qualified expert. Also, the author is not responsible for any unauthorized changes or omissions to the form. Revised March 8, 2016.

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