Application Form

EMPLOYMENT APPLICATION

Prospective employees will receive consideration without discrimination because of race, creed, color, sex, age, national origin, handicap or veteran status.

Step 1 of 7

APPLICANT INFORMATION

First Name

M.I.

Last Name

Today’s Date

MM slash DD slash YYYY

Street Address

Apartment/Unit #

City

State

ZIP

Date Available

MM slash DD slash YYYY

Desired Salary

Position Desired: (check those that apply)

Landscape

Compost Site

Garden Centers

Other:

Are you a citizen of the United States?

YES

If no, are you authorized to work in the U.S.?

YES

Have you ever worked for this company?

YES

If so, when?

Have you ever been convicted of a felony?

YES

If yes, explain

EDUCATION

High School

Address

From

MM slash DD slash YYYY

Did you graduate?

YES

Degree

College

Address

From

MM slash DD slash YYYY

Did you graduate?

YES

Degree

Other

Address

From

MM slash DD slash YYYY

Did you graduate?

YES

Degree

REFERENCES

Please list up to three references.

Full Name

Relationship

Company

Phone

Address

Full Name

Relationship

Company

Phone

Address

Full Name

Relationship

Company

Phone

Address

Barnes is a participant in the Ohio Bureau of Workers’ Compensation Drug-Free Workplace Program

Driver’s License Number

State

Expiration

Phone

List all violations on your driving record within last 3 years and approx. dates.

NOTE: If you are hired a motor vehicle report will be obtained from the State of Ohio.

PREVIOUS EMPLOYMENT

Company

Phone

Address

Supervisor

Job Title

Starting Salary $

Ending Salary $

Responsibilities

From

MM slash DD slash YYYY

Reason for Leaving

May we contact your previous supervisor for a reference?

YES

Company

Phone

Address

Supervisor

Job Title

Starting Salary $

Ending Salary $

Responsibilities

From

MM slash DD slash YYYY

Reason for Leaving

May we contact your previous supervisor for a reference?

YES

Company

Phone

Address

Supervisor

Job Title

Starting Salary $

Ending Salary $

Responsibilities

From

MM slash DD slash YYYY

Reason for Leaving

May we contact your previous supervisor for a reference?

YES

Company

Phone

Address

Supervisor

Job Title

Starting Salary $

Ending Salary $

Responsibilities

From

MM slash DD slash YYYY

Reason for Leaving

May we contact your previous supervisor for a reference?

YES

Company

Phone

Address

Supervisor

Job Title

Starting Salary $

Ending Salary $

Responsibilities

From

MM slash DD slash YYYY

Reason for Leaving

May we contact your previous supervisor for a reference?

YES

DISCLAIMER AND SIGNATURE

I hereby certify that the facts set forth in the above employment application are true and complete to the best of my knowledge and authorize Barnes Nursery, Inc. to verify their accuracy and to obtain reference information on my work performance. I hereby release Barnes Nursery, Inc. from any/all liability of whatever kind and nature which, at any time, could result from obtaining and having an employment decision based on such information.

Consent(Required)

I understand that, if employed, falsified statements of any kind or omissions of facts called for on this application shall be considered sufficient basis for dismissal.(Required)

Consent(Required)

I understand that should an employment offer be extended to me and accepted that I will fully adhere to the policies, rules and regulations of employment of the Employer. However, I further understand that neither the policies, rules, regulations of employment nor anything said during the interview process shall be deemed to constitute the terms of an implied employment contract.(Required)

Consent(Required)

I understand that any employment offered is for an indefinite duration and at will and that either I or the Employer may terminate my employment at any time with or without notice or cause.(Required)

Signature

Today's Date

MM slash DD slash YYYY

Landscape Services and Compost Site

Part of the activities required to maintain and operate a recycling facility involve duties or tasks that are often overlooked when describing a specific job.

Please respond to the following questions by selecting YES/NO.

1. How many year's experience do you have operating a skid steer?

2. How many year's experience do you have operating a wheel loader?

3. How many year's experience do you have in customer service?

4. Are you willing and able to work weekend and evening hours?

YES

5. Can you operate heavy equipment in a safe manner?

YES

6. How many year's experience do you have driving a dump truck?

YES

7. Do you have horticultural experience?

YES

a. If yes, how many years?

b. Explain your horticultural experiences and knowledge.

8. Can you lift 60 lbs?

YES

9. Can you work well with other employees?

YES

10. Are you willing to try new things and new jobs?

YES

11. Do you have a Class A or Class B CDL?

YES

If you answer no to a question above, please list question # and explain.

please indicate the hours and days you are willing and able to work on a regular basis.

MON

7am-12pm

12pm-4pm

4pm-7pm

TUES

7am-12pm

12pm-4pm

4pm-7pm

WED

7am-12pm

12pm-4pm

4pm-7pm

THURS

7am-12pm

12pm-4pm

4pm-7pm

FRI

7am-12pm

12pm-4pm

4pm-7pm

SAT

7am-12pm

12pm-4pm

4pm-7pm

SUN

7am-12pm

12pm-4pm

4pm-7pm

Signature

Today's Date

MM slash DD slash YYYY

Barnes Garden Centers

Part of the activities required to maintain and operate a retail store involve duties or tasks that are often overlooked when describing a specific job.

Please indicate your feelings regarding these tasks and duties by choosing YES/NO.

1. Stock and dust shelves?

YES

2. Dress to our standards.

YES

3. Approach all customers with a smile?

YES

4. Clean the bathrooms?

YES

5. Sweep and Mop the floors?

YES

6. If applicable, smoke in designated areas only?

YES

7. Maintain a positive attitude?

YES

8. Stand on your feet for long periods of time?

YES

9. Operate a computerized register?

YES

10. Clean windows and glass?

YES

11. Work weekend and evening hours?

YES

12. Move boxes and stock safely?

YES

13. Make phone calls to people you don't know?

YES

14. Work at a quick pace?

YES

15. Work as a team?

YES

16. Report to work on time when scheduled?

YES

17. Follow Standard Operating Procedures?

YES

18. Work outside in inclimate weather?

YES

19. Get dirty?

YES

20. Lift up to 40 lbs?

YES

21. Suggestive sell?

YES

22. Try new things and new jobs?

YES

If you answer no to a question above, please list question # and explain.

Please indicate any hours or days you are unavailable to work:

Signature

Today's Date

MM slash DD slash YYYY

Name

This field is for validation purposes and should be left unchanged.

Our Huron Team

Jen, Jess and Ashleigh have served front and center of Barnes Retail Operation for many years. They know their stuff and is always ready to help you find what you need.

Our Catawba Team

Tyler has led our Catawba Store for 10 years. Tyler knows his plants and loves to get to know every customer who walks through the door.

EMPLOYMENT APPLICATION

APPLICANT INFORMATION

EDUCATION

REFERENCES

PREVIOUS EMPLOYMENT

DISCLAIMER AND SIGNATURE

Landscape Services and Compost Site

Barnes Garden Centers

Our Huron Team​

Our Catawba Team

Our Huron Team