Application for Employment

So you have decided to pursue a career working with MRW Lawns? Great! Please fill out the form below, and if you are a match to one of our open positions, we will contact you for a meeting. We keep all applications on file, so if we do not currently have an open position, we will contact you as soon as one becomes available.

JOB APPLICATION

This application will not be used for limiting or excluding an applicant from consideration for employment on a basis prohibited by local, state or federal law. MRW Lawns, Inc. is an equal opportunity employer.

All Fields are REQUIRED!
If you do not have an answer for a question, or it does not apply to you, please enter NA in the field.

Applicant’s Full Name

First Name

Middle Initial

Last Name

Complete Address

Address

City

State

Zip Code

How long have you lived at your current address?

Previous Address

Address

City

State

Zip Code

Info

Phone

Date of Birth

Social Security Number

Driver License Number

State of License

Employment Position

Position for which you are applying

How did you hear about the position?

If hired, date you can start?

Job Skills & Qualifications

Please list the qualifications you possess for this position:

License Information

Section 383.21 FMCSR states “No person who operates a commercial motor vehicle shall at any time have more than one driver’s license.”
I certify that I do not have more than one motor vehicle license, the information for which is listed below.

State

License Number

Type

Class

Expiration Date

Additional License Information

Please Enter NA in Any Empty Fields

Do you have a DOT Medical Certification?

If so, when does it expire?

Do you have a CDL Drivers License?

If so, when does it expire?

Can you pass a Background Check?

Can you pass a Drug Check?

Equipment Experience by Class

Please Enter NA in Any Empty Fields

Straight Truck

Type (Van,Tank,Flat,Etc.)

Date From

Date To

Number of Miles (Total)

Tractor & Semi Trailer

Type (Van,Tank,Flat,Etc.)

Date From

Date To

Number of Miles (Total)

Tractor with Two Trailers

Type (Van,Tank,Flat,Etc.)

Date From

Date To

Number of Miles (Total)

Other

Please Explain & Include Same Info As Above

Accident Record for Past Three Years

Please Enter NA in Any Empty Fields

Accident #1

Date

Nature of Accident (Rear-End, Head-On, Etc)

Number of Fatalities (or None)

Number of Injuries (or None)

Chemical Spill? (Y/N)

Accident #2

Date

Nature of Accident (Rear-End, Head-On, Etc)

Number of Fatalities (or None)

Number of Injuries (or None)

Chemical Spill? (Y/N)

Accident #3

Date

Nature of Accident (Rear-End, Head-On, Etc)

Number of Fatalities (or None)

Number of Injuries (or None)

Chemical Spill? (Y/N)

Other

Please Explain & Include Same Info As Above

Traffic Convictions & Forfeitures for Past Three Years

Other than Parking Violations. (Please Enter NA in Any Empty Fields)

Conviction #1

Date Convicted

Violation

State of Violation

Penalty (Forfeited Bond, collateral, and/or points)

Conviction #2

Date Convicted

Violation

State of Violation

Penalty (Forfeited Bond, collateral, and/or points)

Conviction #3

Date Convicted

Violation

State of Violation

Penalty (Forfeited Bond, collateral, and/or points)

Other

Please Explain & Include Same Info As Above

License Denials & Suspensions

Have you ever been denied a license, permit, or privilege to operate a motor vehicle? (Y/N)

If Yes, Please Explain – If No, Please Enter NA

Has any license, permit, or privilege ever been suspended or revoked? (Y/N)

If Yes, Please Explain – If No, Please Enter NA

Employment History

Applicants that desire to drive in intrastate/interstate commerce must provide the following information on all employers during the previous three years. You must give the same information for all employers for whom you have driven a commercial motor vehicle for the seven years prior to the initial three years (total of ten years employment record.

Employment History #1

Current Employer Name

Supervisor

Job Title

Pay

Phone Number

Start Date

End Date

Reason for Leaving

Description of Duties

Employment History #2

Previous Employer Name

Supervisor

Job Title

Pay

Phone Number

Start Date

End Date

Reason for Leaving

Description of Duties

Employment History #3

Previous Employer Name

Supervisor

Job Title

Pay

Phone Number

Start Date

End Date

Reason for Leaving

Description of Duties

Special Regulations

Were you subject to the Federal Motor Carrier Safety Regulations (FMCSRs) while employed by the previous employer? (Y/N)

Was the previous job position designated as a salary sensitive function in any DOT regulated mode, subject to alcohol and controlled substances testing requirements as required by 49 CFR Part 40? (Y/N)

Gaps in Employment?

Any Gaps in Employment must be explained. Provide reason(s) and dates unemployed

Education

Highest Grade Completed

Name of School

City

State

High School Diploma or Equivalent? (Y/N)

Name of College

Degree Received

Degree of Study

Date Start

Date End

Please provide three (3) Professional References

Professional Reference Name #1

Phone Number

How many years acquainted

Professional Reference Name #2

Phone Number

How many years acquainted

Professional Reference Name #3

Phone Number

How many years acquainted

To be Read and Digitally Signed by Applicant

I authorize MRW Lawns, Inc. to make investigations and inquiries to my personal, employment, financial or medical history and other related matters as may be necessary in arriving at an employment decision. (Generally, inquiries regarding medical history will be made only if and after a conditional offer of employment has been extended. I hereby release employers, schools, health care providers and other persons from all liability in responding to inquiries and releasing information in connection with my application.

In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge. I understand also, that I am required to abide by all rules and regulations of MRW Lawns, Inc. I understand that information I provide regarding current and/or previous employers may be used, and those employer(s) may be contacted. I understand that I have the right to: 1) review information provided by current/previous employers; 2) have errors in the information corrected by previous employers and for those previous employers to re-send the corrected information to the prospective employer; and 3) have a rebuttal statement attached to the alleged erroneous information, if the previous employer(s) and I cannot agree on the accuracy of the information.

This also certifies that I completed this application, that the digital signature below represents my legal signature, and that all entries contained herein are true and complete to the best of my knowledge.

Application Date

Applicant’s Signature

ERROR – ALL FIELDS ARE REQUIRED!

Please ensure all fields have been filled out.

If you do not have an answer for a question, please enter NA in the field.

Thank You!

Position: Lawn Care Technician

Application for Employment

JOB APPLICATION

ERROR – ALL FIELDS ARE REQUIRED!