Careers Step 1 of 5 20% I. Personal Information First Name*Last Name*Date* Email* Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Federal law prohibits the employment of unauthorized aliens. All persons hired must submit satisfactory proof of employment authorization and identity (valid driver’s license, birth certificate, Green Card, etc.) within three days of being hired. Failure to submit such proof within the required time shall result in immediate employment termination.Social Security Number*Phone*Position Applied For*1. Is there any information we would need about your name or use of another name for us to be able to check your work record? Please specify:*2. Do you have any relatives who are presently (or have formerly been) employed by Moss Greenhouses Inc.?*3. Have you ever worked on a farm, another greenhouse or in the agriculture industry?*YesNoWho for and explain your job function.*How were you referred to Moss Greenhouses Inc.?*Have you ever been convicted of a felony?*YesNoPlease Explain* Save and Continue Later II. Educational History List*School Name/LocationYear CompletedDegree Diploma Do you have any special training?*Do you have any special certifications?*What languages do you speak?* III. Computer Skills What is your experience with computer hardware?*What computer softwares do you feel proficient with?* IV. Military Training If applicablePlease describe any military training you may have. Save and Continue Later V. Employment Record Please include all employment for the last five years. Tell us about your work experience*Company NamePosition HeldAddressDates Employed (From-To)Manager/SupervisorTelephoneWage/SalaryReason for Leaving VI. References Please do not include relative or former employers Please list your references below.*NameAddressOccupationYears KnownTelephone Save and Continue Later VII. Bonding Administrative Staff Only Have you ever been bonded?*YesNoHave you ever been refused bonding?*YesNoPlease explain.* VIII. Work AvailabilityIf your application receives favorable consideration, when will you be available to begin work?* Do you have any objection to working overtime?*YesNoCan you work overtime without prior notice?*YesNoPlease list times you are available to work.*SundayMondayTuesdayWednesdayThursdayFridaySaturday IX. Salary / Hourly Rate RequirementsIf your application receives favorable consideration, what salary / hourly rate would you desire?* Save and Continue Later X. Authorization I certify that the facts contained in this application (and resume, if any) are true and complete to the best of my knowledge. I understand that any false statement, omission, or misrepresentation of this application is sufficient cause for refusal to hire, or dismissal if I have been employed, no matter when discovered by the Company. I understand that any employment is conditioned on a background check. I authorize the Company to thoroughly investigate all statements contained in my application or resume, and I authorize my former employers and references to disclose information regarding my former employment, character and general reputation to the Company, without giving me prior notice of such disclosure. In addition, I release the Company, any former employers and all references listed above from any and all claims, demands or liabilities arising out of or related to such investigation or disclosure. I understand and agree that nothing contained in this application, or conveyed during any interview, is intended to create an employment contract. I further understand and agree that if I am hired, my employment will be “at will” and without fixed terms, and may be terminated at any time, with or without cause and without prior notice, at the option of either myself or the Company. No promises regarding employment have been made to me, and I understand that no such promise or guarantee is binding upon the Company unless made in writing. I understand that Moss Greenhouses Inc. has a strict policy against substance abuse. As such, I may be required to take a pre-employment drug test. I also understand that this test will be at the expense of the company. Refusal to take the test will result in my not being considered for this position. If I am hired, a condition of employment will be that I abide by the Company’s Drug and Alcohol Policy. I further understand that filling out this form does not indicate there is a position open and does not obligate the Company to hire. If hired, I agree to abide by all Company work rules, policies and procedures. The Company retains the right to revise its policies or procedures, in whole or in part, at any time.Date* Signature*CommentsThis field is for validation purposes and should be left unchanged. Save and Continue Later This iframe contains the logic required to handle Ajax powered Gravity Forms.