Application For Employment

Name:

Date of Birth

Address:

City:

State:

Zip:

Home Phone #:

Cell #

Part Time / Full Time

What date would you be available to start

Currently Employed:

Where:

If not employed, why did you leave your last job?

Do you have a current Kansas drivers license?

Do you have your own vehicle?

Have you had any moving violations within the past 3 years?

Have you ever worked for a lawn sprinkler company?

If so, where and for how long?

What were your primary duties and responsibilities?

Advancement in our company depends largely on your mechanical and / or electrical skills and ability as well as a good understanding of hydraulics. Please rate yourself on a scale of 1 to 10 (with 10 being the highest) on those skills

Have you ever been convicted of a felony within the last 5 years?

If yes, please explain. (Will not necessarily exclude you from consideration)

This job will demand physical labor. Do you have any medical conditions or concerns that could affect your job performance?

If yes, what are these conditions?

Authorization:

I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for dismissal. I authorize investigation of all statements contained herein and release Aqua Sprinkler Systems from all liability for any damage that may result from utilitization of such information.

Date:

Name: