Mr. Mulch, Inc.
2721 W. State Route 161
Columbus, OH 43235
(614) 792-8686

APPLICATION FOR EMPLOYMENT
Part 1. GENERAL INFORMATION:
Name
First
Middle
Last
Current Address
Street
City
State
Zip
Permanent Address
Street
City
State
Zip
Home Phone Alternate Phone Email Address
Social Security Number Are you 18 years or older?  
Position Applying for: Yard Supervisor Full Time Seasonal   Part Time Seasonal
I'd also like to apply for: Sales Associate   Customer Service Rep   Accounts Receivable Clerk  
Delivery Driver   Yard Laborer   Skid Steer Operator   Dispatcher  
 
How did you hear about us?
Have you ever been employed by this company? Dates:   From
Month/Year		 To
Month/Year
Were you referred? Who referred you? Expected Pay Rate:
Part 2. EDUCATION:
Are you a high school graduate or have you passed a general education development (GED) exam?
DiplomaGEDIf not, highest grade completed
If you are still in high school:

School Name & Location
Dates Attended
Class

Cumulative GPA
Area of Study
List post high school training, including college, business school, military training, and other relevant education.
1.)  
     School Name & Location
Dates Attended
Total Credits Earned
     
     Cumulative GPA
Major
Degree Earned?
 
2.)  
     School Name & Location
Dates Attended
Total Credits Earned
     
     Cumulative GPA
Major
Degree Earned?
 
3.)  
     School Name & Location
Dates Attended
Total Credits Earned
     
     Cumulative GPA
Major
Degree Earned?
Part 3. EMPLOYMENT HISTORY:
1.  Present or Last Employer  Employer's Phone Number
     Employer's Address
     Your Title  Dates Employed
     Last Wage  Supervisor's Name
     If currently employed, may we contact the employer?
     Reason for Leaving?
     Specific Duties:
 
2.  Previous Employer  Employer's Phone Number
     Employer's Address
     Your Title  Dates Employed
     Last Wage  Supervisor's Name
     If currently employed, may we contact the employer?
     Reason for Leaving?
     Specific Duties:
 
3.  Previous Employer  Employer's Phone Number
     Employer's Address
     Your Title  Dates Employed
     Last Wage  Supervisor's Name
     If currently employed, may we contact the employer?
     Reason for Leaving?
     Specific Duties:
Part 4. Background Information:
Have you ever been charged or convicted of a felony?
If yes, briefly explain and you may be asked to explain in further detail at a later time.
Conviction or being charged of a crime is not an automatic bar to employment, all circumstances will be considered.
All potential employees are subject to random drug tests once employed by Mr Mulch, Inc.
Part 5. References:
Please list three references that we may contact. Please list teachers, professors, supervisors, etc.
Name Relationship
Company Name How long have you known this person?
Phone Number
 
Name Relationship
Company Name How long have you known this person?
Phone Number
 
Name Relationship
Company Name How long have you known this person?
Phone Number
Part 6. QUESTIONS:
  1. Where did you hear about the job opening?
  2. Why do you want to work at Mr. Mulch?
  3. What unique characteristics or skills do you possess that would make you a better candidate than others for this job?
  4. If you did not set an alarm clock, what time would you wake up in the morning?
  5. Do you have reliable transportation to work?
  6. How long do you intend to work for this company?
Part 7. DATE AND SIGNATURE:

To be considered for employment, you must provide your electronic signature below.
All answers and statements are true and complete to the best of my knowledge. I understand that Mr. Mulch, Inc. may verify information, and that untruthful or misleading answers are cause for rejection of this application or dismissal if employed.
Check this box to certify that you have read and accepted the above statement.
Date:   Name:

Number of Weekly Hours Requested:
Name: Available Start Date (very important):
P = PREFERRED SCHEDULE
UA = UNAVAILABLE
NP = NOT PREFERRED, BUT AVAILABLE
 MondayTuesday Wednesday Thursday Friday Saturday Sunday
6:00 – 7:00
AM
7:00 – 8:00
AM
8:00 – 9:00
AM
9:00 – 10:00
AM
10:00 – 11:00
AM
11:00 – 12:00
NOON
12:00 – 1:00
PM
1:00 – 2:00
PM
2:00 – 3:00
PM
3:00 – 4:00
PM
4:00 – 5:00
PM
5:00 – 6:00
PM
6:00 – 7:00
PM
7:00 – 8:00
PM
8:00 – 9:00
PM

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