Employment Application Form

Job Application Form

DATE
MM slash DD slash YYYY
POSITION APPLIED FOR?
Please check all that apply.
- Seasonal Cashier
- Delivery Driver
- Commodities Team
- Garden Store Retail Sales
- Gift Boutique Customer Service
- Office Administrator
- Greenhouse Customer Service
- Outdoor Nursery Customer Service
- Commercial Greenhouse Team
NAME
First Last Preferred Pronoun
ADDRESS
Street Address City Province Postal Code
PHONE
EMAIL
ARE YOU INTERESTED IN?
Please check all that apply.
- Full Time
- Part Time
- Seasonal
DAYS & HOURS AVAILABLE TO WORK?
Please check all that apply.
- DAYS: Monday-Friday
- EVENINGS: Monday-Friday
- WEEKENDS: Saturday-Sunday
WHAT ARE THE NUMBER OF HOURS YOU WANT TO WORK PER WEEK?
Maximum Minimum
HAVE YOU WORKED HERE BEFORE?
- Yes
- No
IF YES, PLEASE STATE YOUR PREVIOUS POSITION AND DATE:
PLEASE RESPOND TO THE FOLLOWING QUESTIONS:*
Our retail operation has several different types of positions. Each position has essential job functions. Please check all that apply.
- Do you have your own transportation (bus service is not available)?
- Can you walk and stand on the job for extended periods of time?
- Can you work in hot and humid and/or cool and damp environments?
- Can you lift heavy items that weigh up to 50 lbs?
- Can you frequently bend, squat, lift, carry, push and pull?
- Are you able to work around chemicals, pesticides, cleaning solvents, etc?
- Have you ever operated motorized equipment (forklifts or bobcats)?
- Do you have experience with cash registers/handling bank transactions?
- Do you have previous experience in a retail/customer service setting?
- Do you have experience creating visual displays with merchandise?
- Do you have previous experience in a greenhouse setting?
WHY DO YOU WANT TO WORK AT SHELMERDINE?
TELL US A BIT ABOUT YOURSELF
EDUCATION
Please indicate highest level of education completed.
POST SECONDARY EDUCATION
Name of University/College Years Completed Did you graduate? Degree/Diploma/Certificate
REFERENCES
Please provide up to three (3) business references, starting with your most recent job. If you do not have any employment-related references, please list one (1) personal reference (do not include relatives).
Company Name Phone Address Date Employed Position Duties Reason for Leaving
APPLICANT AGREEMENT*
I hereby certify that the facts set forth in the above employment application are true and complete to the best of my knowledge. I understand that, if employed, falsified/eliminated statements contained on this application shall be considered sufficient cause for dismissal.
Signature (print name) Date

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Company Name	Phone	Address	Date Employed	Position	Duties	Reason for Leaving