Employment Application

10112 DeChaux Rd. E. ● Edgewood, WA 98371 ● Store 253-770-POND (7663) ● Cell 253-921-4747

Application For Employment

Thanks for your interest in Living Waters Garden Market. Please provide the following information and click Submit below.

Applicant Data:
How were you referred to us?:
Full Name:
Address:
City:		State	Zip
Phone:
Mobile / Pager:
E-Mail:
Date Available To Start:
Salary Requirements:

If you are under 18 years of age, can you provide a work permit? Yes No
If no, please explain:

Have you ever worked for Living Waters Garden Market? Yes No
If yes, when?:

Are you a citizen of the United States? Yes No
If not, are you legally allowed to work in the United States?Yes No

Type of Employment Desired:	Full Time Part Time Temporary Seasonal

Have you ever pleaded guilty, no contest or been convicted of a crime? Yes No
If yes, give dates and details:

Answering yes to these questions does not constitute an automatic rejection for employment. Date of the offense, seriousness and nature of the violation, rehabilitation and position applied for will be considered.

Driver's License Number:	State:


Please summarize your special skills or qualifications:


Previous Employment (begin with most recent position):
*Position #1*
Dates of Employment:	From To
Position(s) Held:
Company Name:
Address::
City:		State	Zip
Phone:
Supervisor	Title
E-Mail:
Responsibilities:
Starting Salary & Title
Ending Salary & Title
Reason For Leaving:
May we contact this employer for a reference? Yes No

*Position #2*
Dates of Employment:	From To
Position(s) Held:
Company Name:
Address::
City:		State	Zip
Phone:
Supervisor	Title
E-Mail:
Responsibilities:
Starting Salary & Title
Ending Salary & Title
Reason For Leaving:
May we contact this employer for a reference? Yes No


*Position #3*
Dates of Employment:	From To
Position(s) Held:
Company Name:
Address::
City:		State	Zip
Phone:
Supervisor	Title
E-Mail:
Responsibilities:
Starting Salary & Title
Ending Salary & Title
Reason For Leaving:
May we contact this employer for a reference? Yes No


I certify that my answers are true and complete to the best of my knowledge. I authorize you to make such investigations and inquiries of my previous employment, educational, financial and other related matters as may be necessary for an employment decision. I hereby release employers from all liability when responding to inquiries in connection with my application. In the event I am employed, I understand that false or misleading information given in my application or interview(s) may result in discharge. By clicking yes, I acknowledge that I agree to these terms. Yes
Thanks again for your interest in Living Waters Garden Market.

SSL