Application
Visit https://goo.gl/forms/PADfzz6Fr6gX8HW32 to upload your resume. Note that you will need to have a Google account and sign in to send your resume using this form. If you do not have a Google account and prefer to use your email client, please call 800-875-1392 for email instructions.
I will send a copy of my resume using the upload form (see directions above). *
Date of Application *
MM
/
DD
/
YYYY
Last Name *
First Name *
Middle Initial
Email address *
Position Applied For
Salary Expected *
Telephone Number With Area Code *
Street Address *
Apartment Number
City *
State *
Postal Code *
Are you at least 16 years old? *
Are you at least 18 years old? *
Do you have a valid driver's license? *
Educational History
High School
Enter the name of the high school you attended most recently/graduated from
Where is the educational facility located (high school)?
How many years did you attend this institution (high school)?
What was your major course of study at this institution (high school)?
What were your average grades at this institution (high school)?
Did you graduate from this institution (high school)?
Clear selection
College or university
Enter the name of the college you attended most recently/graduated from
Where is the educational facility located (college or university)?
How many years did you attend this institution (college or university)?
What was your major course of study at this institution (college or university)?
What were your average grades at this institution (college or university)?
Did you graduate from this institution (college or university)?
Clear selection
Other education
Do you have any other education you would like to include?
Where is the educational facility located (other)?
How many years did you attend this institution (other)?
What was your major course of study at this institution (other)?
What were your average grades at this institution (other)?
Did you graduate from this institution (other)?
Clear selection
What school activities and organizations including athletics did you participate in?
What scholastic honors did you receive?
Background
Have you ever been convicted of a felony?
Clear selection
If yes, please explain in detail.
Do you speak, read or write any language other than English?
Clear selection
List any languages other than English you speak below.
Are you fluent in any of the above languages?
Have you ever been an employee of Hortech, LiveRoof, or LiveWall?
Clear selection
If so, when?
Please list any relatives that are currently employees of Hortech, LiveRoof, and LiveWall
How did you hear about us?
Did you serve in the military?
Please enter your M.O.S.
Did you attend a service school?
What were your dates of service
What was your highest rank achieved?
Employment History
Start with most recent first.
Employer 1 name of company
Employer 1 address
Employer 1 telephone number
Employer 1 job title
Employer 1 dates employed
Employer 1 supervisor
Employer 1 job duties
Employer 1 reason for leaving
Employer 1 starting rate/salary
Employer 1 final rate/salary
Employer 2 name of company
Employer 2 address
Employer 2 telephone number
Employer 2 job title
Employer 2 dates employed
Employer 2 supervisor
Employer 2 job duties
Employer 2 reason for leaving
Employer 2 starting rate/salary
Employer 2 final rate/salary
Employer 3 name of company
Employer 3 address
Employer 3 telephone number
Employer 3 job title
Employer 3 dates employed
Employer 3 supervisor
Employer 3 job duites
Employer 3 reason for leaving
Employer 3 starting rate/salary
Employer 3 final rate/salary
Indicate any of the above employers whom you do not wish us to contact
What other special qualifications do you have that are not listed above?
Briefly state why you would like to work with our company
What are your future educational plans/hopes/desires?
What are your future career plans/hopes/desires (responsibilities, wages, salary, etc.)?
Do we have permission to check all information?
Clear selection
Do you have the required documents to permit you to work?
Clear selection
Authorization and Understanding
We are an equal opportunity company. we are dedicated to a policy of non-discrimination in employment on any basis including race, creed, age, sex, religion, national origin, height, weight, marital status, or handicap.

Upon the signing of this application, I represent that all of the information now or hereafter given by me in support of my application is true and complete. I authorize you to verify any of the information concerning my background, including but not limited to, my employment, driving record, education, criminal history, or medical history (post-offer only), with the appropriate individuals, companies, institutions or agencies, and I authorize them to release such information as you require, including my prior disciplinary employment record, without obligation to give me written notice of such disclosure. I hereby release you and them from any liability whatsoever as a result of any such inquiries and disclosures and this release from liability does not waive or prohibit an individual from filing a charge of discrimination under the laws enforced by the EEOC. I agree that any false information in support of my application may subject me to discharge at any time during the period of my employment.

I agree that either party may terminate the employment relationship, with or without cause, at any time, and further agree that this arrangement may only be altered in writing directed to me personally and signed by the president of the firm. I agree that I shall be bound by the other rules, policies, regulations and terms and conditions of employment of the firm as they are from time to time changed, and no additional obligations can be imposed on the firm except those which have been acknowledged in writing, by the president or his designated representatives. I hereby authorize the firm to deduct from each and every period of my pay any amounts necessary to offset any damages caused by me or the value of property or money entrusted to me by, or owed by me to the firm during the course of my employment.

I agree that any action or suits against the firm, its agents or employees, arising out of my employment or termination of employment including, but not limited to, claims arising under State, but not Federal, civil rights statues, must be brought within 180 days of the event giving rise to the claims or be forever barred unless the applicable stature of limitations period is shorter than 180 days in which case I will continue to be bound by that shorter limitations period. I waive any limitation period to the contrary. I further agree that if I should bring any non-statuary action or claim arising out of my employment against the firm, in which the firm prevails, I will pay to the firm any all such costs incurred by the firm in defense of claims or actions, including attorney fees. I further agree that my employment is conditional until such time as the results of my post-offer physical (if such physical is required) are known.
Authorization *
I have read and agree to the above terms.
Required
Signature *
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