The Dow Gardens - Application for Employment

Today's Date: Date Available for Employment:

Section 1

PERSONAL

Are you 18 years of age or older: Yes No

Home Phone: Cell Phone:

Name (First, Last, M.I.):

Street Address:

City, State & Zip Code:

Emergency Contact: Relationship:

Telephone:

Address, City, State:

Section 2.

EDUCATION

College/Technical/Trade School:

Area of Study:

Address, City, State, Zip

Telephone (include Area Code): Degree Achieved: Choose One: Skilled Trades Journey Man Some College Associates Degree Bachelor's Degree Master's Degree PhD

Additional Information: Please share any information that would be helpful to us concerning your educational experience. This may include any associations, certifications or continuing education you have attend or are a member.

High School:

Graduation Date: Diploma G.E.D.

Address, City, State, Zip

Telephone (include Area Code):

Additional Information: Please share any information that would be helpful to us concerning your educational experience. This may include any extra-curricular activities such as Key Club, National Honor Society, Music and Sports Teams.

Section 3.

PREVIOUS WORK EXPERIENCES

Please provide current or previous employment, beginning with the most current.

1.

Dates of Employment (To/From):

Name of Employer:

Supervisor's Name and Title:

Address (include City, State, ZipCode):

Telephone Number (include Area Code):

Position Held: Rate of Pay:

Reason for Leaving:

2.

Dates of Employment (To/From):

Name of Employer:

Supervisor's Name and Title:

Address (include City, State, ZipCode):

Telephone Number (include Area Code):

Position Held: Rate of Pay:

Reason for Leaving:

3.

Dates of Employment (To/From):

Name of Employer:

Supervisor's Name and Title:

Address (include City, State, ZipCode):

Telephone Number (include Area Code):

Position Held: Rate of Pay:

Reason for Leaving:

Section 4.

PERSONAL/PROFESSIONAL REFERENCES

1. Name (First, Last, M.I.):

Street Address:

City, State & Zip Code:

Telephone: Years Known:

2. Name (First, Last, M.I.):

Street Address:

City, State & Zip Code:

Telephone: Years Known:

3. Name (First, Last, M.I.):

Street Address:

City, State & Zip Code:

Telephone: Years Known:

The Undersgined hereby authorizes investigation of all matters contained in this application and also authorizes previous employers and references listed to provide any information requested of them by the Dow Gardens. The undersigned further agrees and understands that if any statment made, or if any information provided, by the undersigned is false or is in any way a misrepresentation, the Dow Gardens may in its sole descretion, immediately terminate my employment without any obligation or liability to me other than for payment, at the rate agreed upon, for services actually rendered. Furthermore, the undersigned understands and agrees that all employees of the Dow Gardens are employees At-Will and can be terminated at any time, with or without notice. Employees, of course, may terminate their employement at at time. No Supervisor or employee of the Dow Gardens, other than the Managing Director has authority to enter into an employment contract with an employee or to change the employment relationship to anything other than an At-Will employment relationship. Any such employment contract or change of employment relationship must be in writing and signed by the Managing Director before it will be deemed effective.

Upon an offer of employment with the Dow Gardens, you shall be required to undergo a Medical Examination before you actually start your job. The job offer made to you will be conditioned upon the results of the examination. A sixty (60) day probationary performance period is required of all new employees. At the end of the probationary period your performance will be reviewd and a decision made about continued employment with the Dow Gardens.

Signature:______________________________________ Date____________________