Contact Information

Name:

Email Address:

Address:




Telephone Number:

Social Security Number:

Are you under 18 years old?

YesNo

In case of emergency, contact:

Contact Name Phone Number
1.
2.

Education History

Name of School/College Last Grade Completed Diploma/Degree Earned
1.
2.
3.

Employment History

List three most recent positions, starting with last position held.

Company (Name, Location, Supervisor, Contact) Position Dates Held
1.
2.
3.

References

Name Occupation Relationship
1.
2.
3.

Experience

Check boxes that apply. Give description if applicable. Include years of experience if applicable.

Administrative










Production














Training/Qualification/Licenses




















Driver Skills/Qualifications

Check your valid, current licenses:

Valid driver’s license state/number:

Years of experience driving a CDL A truck:

Years of experience driving a CDL B truck:

Years of experience driving a CMV vehicle (over 10,000 GVWR):

I have driven a chip truck/towed chipper, list years of experience:

I have driven a bucket truck/towed chipper, list years of experience:

I have been in a commercial vehicle accident in the past three years, list those accidents, type of accident, and fatalities and injuries to others (do not list injuries to yourself):



I have been denied a license, permit, and/or privilege to operate a motor vehicle, explanation:



I had a license, permit, and/or privilege to operate a motor vehicle suspended and/or revoked, explanation:


Notes: Federal DOT regulations require checks on all drivers. Attach an additional sheet if more space is needed to list accidents and/or provide explanations.

Application Verification and Acknowledgement – Please Read Carefully

Ability to Perform Essential Functions of the Job (All Production Positions): All production positions are physically demanding. Entry-level employees in these positions are expected, within a reasonable time after they commence employment, to be able to do tree work. This work includes climbing trees and removing tree limbs using various hand and power tools on a continuous basis during an eight to ten hour shift; removing and disposing of tree limbs using various mechanized tools, which can require bending, lifting, and carrying from 50 to 100-pound loads, manually climbing trees and ability to safely determine and maintain minimum separation from live overhead power lines. Entry-level employees may also be required to obtain state licenses to apply pesticides and engage in duties that require exposure to various chemicals and pesticides.

Are you physically able to safely perform these job duties with or without a reasonable accommodation?

YesNo

Employment “at will” agreement: In consideration of my employment, I agree to conform to the employment policies of American Arbor, LLC. I agree that my employment is “at will,” is not to be for any specific duration, and that I may resign or be terminated an any time without advance notice or cause to the need of me or the Company to follow any particular procedure. I also agree that my employment is not subject to any express, implied, or oral contract, or promise and that the Company’s employee handbook (if any) and personnel-related documents as they now exist or may be issued or revised in the future, are not to be regarded as such by me. I further agree that no supervisor or manager of the Company has any authority to make any oral or written promise or agreement inconsistent with the foregoing, other than the president of the Company, in writing, signed by him / her.

Handbook not an express or implied contract: The Company, policies, and memoranda are a collection of general guidelines and information. They are not, nor are they intended to be, relied upon as an express or implied contract nor as a promise of any kind, nor promise to follow any particular procedure in discipline or other matters. I acknowledge that these materials may be changed at any time by the Company.

Agreement that any offer of employment is contingent: I understand and acknowledge that any offer of employment is expressly conditioned upon my completion of a lawful, job-related pre-employment medical questionnaire, a review by the company's physicians of responses to that questionnaire, satisfactory completion of any lawful job-related medical examinations that may be required by the company, and a determination by the company that I am qualified to safely perform the job sought without a significant risk of future injury to myself or others. I further understand that even though this review process may take several weeks, any offer of employment remains conditional until it has been approved by the company's personnel officer.

Reference check agreements: (1) I understand and agree that it is the Company’s policy to disclose in response to a prospective employer's request only the following information about current or former employees: (1) The dates of employment; and, (2) Title of jobs performed. I agree to direct any employment references about my employment to the Company’s director of human resources and not to any other person of the Company (and hereby release the company from any claims about references about my employment made or directed to others.

(2) Applicant also authorizes the Company, as my prospective employer and also my prior employers, to give candid references concerning my work and character and promise not to make any claim against the Company OR against any such past, present or future employers or the representatives of any of them, for content of any such employment reference given with respect to me, and applicant authorizes the Company to show this agreement to any such prior employer to assure them they may safely respond to our inquiry about you without fear of liability from you for doing so.

Enter your full name and date to acknowledge your agreement with the above.