Employment Application – Lukas Nursery

Contact Information

Name*

First Last

Email*

Phone*

Address*

Street Address Address Line 2 City State ZIP Code

How long have you lived at this address?*

Please Answer the Following:

Are you over 18?*

Position you are applying for*

Please explain your qualifications and why you would be the best candidate for this position*

Wage Desired*

Number of hours you prefer to work each week*

Days/Hours you are available to work

Please enter the time of day in which you are available (i.e. 8 am - 6 pm).

If hired, when can you start?*

If hired, the hours you have listed will be taken into consideration in our scheduling process. If you have any conflicts, please list them.

How long do you plan to work?*

Have you worked for us before?*

Please tell us the dates you worked and your position.

Are you employed at present?*

Are you currently on a leave of absence or layoff from any company?*

Are you legally eligible to work in the USA?*

Have you ever been discharged from your work?*

Do you have any relatives working for Lukas Nursery?*

Name of Relative*

How did you hear about us?*

Education

Please list any/all schools you attended (starting with high school)

School Name	Location	Years Attended	Major	Graduate?

Use the + on the right to add a new line.

Employment History

List all organizations you've worked for

Company Name	Location	Phone	Date Start - End Date	Supervisor Name	Responsibilities	Reason for leaving

Start with most recent employer. Use the + on the right to add a new line for each additional job.

May we contact any organization listed above?

Can you explain why we can't?*

Work Skills

Please check the box for any work skills you possess.

Check all that apply.*

Upload Your Resume (optional)

Max. file size: 256 MB.

IMPORTANT - PLEASE READ AND ACKNOWLEDGE

Consent*

I agree and consent to the terms of this application.

Applicant herby certifies that the answers to the foregoing questions concerning applicant's physical condition, prior work history and other information are true and correct. I agree if the information is found to be false in any respect including omission of information, I will be subject to dismissal without notice at any time. The applicant understands employer is relying upon applicant's answers and the answers are made as an inducement to employer to hire applicant. I authorize you to investigate all information in this application. I hereby authorize my former employers to release information pertaining to my work record, habits and performance.

I hereby authorize Lukas Nursery to obtain a background investigation report made by a security or consumer reporting agency with respect to me. In so doing, I release the reporting agency, Lukas Nursery and its agents from any and all liability which may flow from the release of such information.

Should I become an employee of Lukas Nursery I understand that my employment will be for no definite term, such that I will enjoy the right to terminate my employment at any time, at my convenience, with or without cause or reason. I further understand that Lukas Nursery will have the same right. This status can only be modified if such modification is in writing and signed by both me and the President of the Company.

I hereby further acknowledge that I am expected to abide by all Company rules and regulations, written or unwritten, promulgated by the Company, my Manager or my supervisor, but that such rules and regulations do not create a contract between me and the Company or otherwise restrict the right of either me or the Company to terminate the employment relationship. I understand and agree any handbook which I may receive will not constitute an employment contract, but will be a statement of the Company's current policies.

I understand that because of the nature of retail operations, the Company reserves the right (except where prohibited by law) to conduct inspections of my person, lockers, bags, (including purses or briefcases) or parcels brought into or taken out of the store. I understand that refusal to submit to a requested inspection may result (except where prohibited by law) in termination of my employment.

I understand that before any offer of employment is finalized, I may be required to submit to blood, urine and/or other medical testing for alcohol, drugs and controlled substances at a Company selected medical facility at the Company's expense.

If the test results demonstrate the presence of undisclosed prescribed or unauthorized drugs or controlled substances or an unacceptable level of alcohol, I understand that I will not be permitted to commence work for the Company, or I will be terminated if I have already commenced work. I voluntarily consent for the designated medical facility to collect urine and blood samples from me and to test for the presence of alcohol, drugs and controlled substances. Further, the medical facility is authorized to release the results of the tests to Lukas Nursery. Lukas Nursery is authorized to communicate the test results internally as it deems appropriate. I may request a copy of this authorization.

Phone

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