Ventura's Greenhouse Application

Personal Information:

NOTE:  Items with an asterisk must be filled in to submit this application.
Name(Last, First) (*)
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Address 1 : (*)
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Address 2 :
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City :
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State  : (*)
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Zip Code  : (*)
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E-Mail : (*)
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Phone :
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Phone 2 :
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Employment Desired:
Position :
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Date You Can
Start :
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Salary Desired :
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Are You
Employed Now? (*)
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If yes, may we inquire of your present employer?
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Are you legally authorized to work in the U.S.? (*)
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Ever applied to this company before?
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Where and when?
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Education History
High School :
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College :
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Trade, Business or other :
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General Information
Subject of special study/research work:
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Special training :
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Special skills :
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U.S. Military or Naval Service :
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Rank :
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Former Employers

List below your last four employers, starting with your last employer first.
Employer 1 : (*)
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Date Employed : (*)
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Salary & Position :
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Reason For Leaving :
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Employer 2 :
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Date Employed :
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Salary & Position :
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Reason For Leaving :
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Employer 3 :
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Date Employed :
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References

Give below the names of three (3) persons not related to you, whom you have known at least one year.
Name:
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Address:
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Business:
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Years known:
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Name:
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Address:
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Business:
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Years known:
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Name:
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Address:
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Business:
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Years known:
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Authorization:

"I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for dismissal.

I authorize investigation of all statements contained herein and the references and employers listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release the company from all liability for any damage that may result from the utilization of such information.

I also understand and agree that no representative of the company has any authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing, unless it is in writing and signed by an authorized company representative.

This waiver does not permit the release of use of disability-related or medical information in a manner prohibited by the Americans with Disabilities Act (ADA) and other relevant federal and state laws."

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