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Westgro Corporation Contract
PO Box 525, Issaquah, Wa. 98027
Phone (425)255-6220 – Fax (425)255-6221
Please Enter Your Information In the Designated Boxes
Today’s Date Social Security Number Phone Number
Email
Last Name First Name Middle Initial
Position Applying for Salary Desired Date Available For Work
Present Street Address City State ZIP Code
Previous Street Address City State ZIP Code
In Case of Emergency Contact: Relationship Emergency Phone number
Are You Age 18 or Older? Will VISA or Immigration Status Prevent Lawful Employment?
How were you referred to this Company?
How Have You Ever Been Convicted of or Pled No Contest to a Crime?
(If Yes, indicate nature of offense, court date, court and disposition)
Employer Name & Address Start Date Start Salary Start Position
Name of Supervisor End Date End Salary End Position
Employer Phone # Reason for Leaving? Eligible For Rehire?
Name of High School Location of School Years Graduate? Majors/Minors
Name of College Location of School Years Graduate? Majors/Minors
Branch of Service Start Date of Service End Date of Service Location Served
Indicate any other skills you may have that related to the position you are seeking?
By submitting this form I certify that the information given by me to Westgro Landscape Management Corporation is true and complete to the best of my knowledge. I understand that if I gave false information during this application process may result in immediate dismissal.
I further certify that I am not engaged in any outside activity or business that could be considered in conflict with Westgro Landscape Management Corporation interest or those of its customers, nor will I become engaged in such activity or business if employed.
I authorize Westgro Landscape Management Corporation to solicit information regarding my education and previous employment, and to contact any and all references I have given on my application. I hereby release all parties and persons connected with any such request for information from all claims, liabilities and damages for any reason arising out of the furnishing of such information. If employed, I release the company from any liability for future references it any provide regarding my work history with Westgro Landscape Management Corporation or myself. I understand that no representative of Westgro Landscape Management Corporation, other than the President/Owner, Has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing.
If employed, I further agree that if Westgro Landscape Management Corporation advances any paid leave before it has been accrued, or advances or loans me any money during the course of my employment, or if I lose, damage, or fail to return any Westgro Landscape Management Corporation property, Westgro Landscape Management Corporation is authorized to deduct from my wages sufficient funds to repay such loans or advances or to replace its property.