Merles Garden Center

Your Information

First Name

Last Name

Phone

Address

City

State

Zip

Desired Position

Wage Desired

When Can You Start?

Are You at Least 18 Years Old?
Yes No

How Did You Hear About This Job?

What High School Did You Attend?

What Month/Year Did You Graduate?

If You Didn't Receive a Diploma, did you get a GED? Yes No N/A

What College/University Did You Attend?

What did you Study?

What Month/Year Did You Graduate?

Anything else we should know about you?

Have You Ever Been Convicted of a Crime (Other than Minor Traffic Offenses)? Yes No

If yes, what was the offense?

Job History

Current/Most Recent Employer

Company Name

Position

Responsibilities

Start Date

End Date

Starting Salary

Ending Salary

Reason for Leaving

Prior Job #1

Company Name

Position

Responsibilities

Start Date

End Date

Starting Salary

Ending Salary

Reason for Leaving

Prior Job #2

Company Name

Position

Responsibilities

Start Date

End Date

Starting Salary

Ending Salary

Reason for Leaving

Reference

Please include a non-family reference.

Name

Relationship

Position

Phone Number