Application for Employment LEI Corporation is an equal opportunity employer and does not discriminate on the basis of race, religion, color, national origin, age, sex, gender, marital status, disability or any other characteristic protected by law. Introductory Information Name* Date* City* State* Zip* Phone* Email* Address* Emergency Contact Name* Relationship* Phone* Applicant Questions Type of worked desired* Salary desired (per year)* Date Available* If hired, can you provide documents required to establish your eligibility to work in the U.S.?* YesNo Are you 18 years of age or older?* YesNo How were you referred to Landscaping Etc., Inc.?* Have you ever been fired from a job or asked to resign?* YesNo If yes, please explain. Education High School or last grade completed* Name & Address of School* Course of Study* Number of years completed* Degree/Diploma* College or Technical School Name & Address of School* Course of Study* Number of years completed* Degree/Diploma* Other Schooling or Training Name & Address of School* Course of Study* Number of years completed* Degree/Diploma* Military Experience Branch of Service* From* To* Rank/Type of Service* Job-Related Training/Experience* Record of Employment List positions (including volunteer positions) starting with most recent 1.Employer Telephone Address Position Title Supervisor Supervisor’s Phone Supervisor’s Email Start Date Date Left Beginning Salary Ending Salary Duties Reason for Leaving Add More Employer 2.Employer Telephone Address Position Title Supervisor Supervisor’s Phone Supervisor’s Email Start Date Date Left Beginning Salary Ending Salary Duties Reason for Leaving Add More Employer 3.Employer Telephone Address Position Title Supervisor Supervisor’s Phone Supervisor’s Email Start Date Date Left Beginning Salary Ending Salary Duties Reason for Leaving Work Related References (Do not include relatives) Sr. No. Name Occupation Years Known Contact Information 1. 2. 3.
