PERSONAL

EDUCATION

PREVIOUS EMPLOYMENT

CONVICTION RECORD

During the last 10 years, have you been convicted of a crime other than a minor traffic offense? (A conviction does not disqualify you from employment. Specific factors of the issue will be considered) 

DRIVER ABSTRACT PERMISSION

World of Green, LLC has permission to request a copy of my driving abstract from the State of Nebraska for the purpose of evaluating for employment.

APPLICANT’S CERTIFICATION AND AGREEMENT

I hereby certify that the facts disclosed in this application are true and complete to the best of my knowledge.  I authorize World of Green to verify their accuracy and to obtain reference information on my work performance.  I release World of Green from any/all liability whatsoever which, at any time, could result from obtaining and having an employment decision based of this information.

I understand that, if employed, any of the above statements found to be false, or relevant information is omitted, could be sufficient basis for termination.

The below check box acts like a signature of applicant.