Application Date *

MM

DD

YYYY

I am interested in the following seasonal positions: *

Ground Crew

Climber

Licensed Arborist

Plant Health Care Tech

Office Crew

Name *

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

AVAILABILTY

Part Time

Full Time

Date you can begin work:

MM

DD

YYYY

Are you under 18? *

Yes

No

Are you currently enrolled in school?

Yes

No

Have you ever had a work-related injury or illness in the past? *

Yes

No

Do you currently have any lifting restrictions? *

Yes

No

Are you prevented from lawfully being employed in the U.S. because of Visa or Immigration Status? *

Yes

No

Do you have transportation to/from work? *

Yes

No

EMERGENCY CONTACT *

First Name

Last Name

Emergency Contact's Phone Number:

(###)

###

####

Desired Start Date: *

MM

DD

YYYY

How did you hear about us? / Who referred you?

First Name

Last Name

PERSONAL REFERENCE #1 *

Include only individuals familiar with your work ability. Do not include relatives.

First Name

Last Name

Phone

(###)

###

####

PERSONAL REFERENCE #2

First Name

Last Name

Phone

(###)

###

####

Phone

(###)

###

####

Start Date

MM

DD

YYYY

End Date

MM

DD

YYYY

Start Date

MM

DD

YYYY

End Date

MM

DD

YYYY

Start Date

MM

DD

YYYY

End Date

MM

DD

YYYY

If currently employed may we contact your current employer?

Yes

No

I have experience with:

Tree Climibing

Using a Stump Grinder

Using a Chain Saw

Using a Chipper

Driving Large Trucks

Backing up Trailers

Operating Excavation Equipment

Leading a crew

Estimating and Sales

Mechanical Repair and Maintenance

Managing People

Do you currently have a Commercial Driver's License?

Yes

No

Will you be sending your resume via email?

You may mail it to: info@telluridearborist.com

Yes

No

I understand that checking this box constitutes a legal signature.