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Employment Application

To be considered for employment, you must complete both parts of the employment application process:

Complete both forms and submit them. Your application will be reviewed. If approved, one of our team members will contact you to set up a telephone interview.

PART 1: Application Form

Applicant Information

Are you a United States citizen?
If not, are you authorized to work in the U.S.?
Have you worked for Primary Grounds before?
Have you ever been convicted of a felony?


Did you graduate?
Did you graduate?
Did you graduate?


Please list three professional references

Previous Employment

May we contact your previous supervisor for a reference?
May we contact your previous supervisor for a reference?
May we contact your previous supervisor for a reference?

I certify that my answers are true and complete to the best of my knowledge.

If this application leads to employment, I understand that false or misleading information in my application or interview 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 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 agreement contrary to the foregoing, unless it is in writing and signed by an authorized company representative.

This waiver does not permit the release or 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.

I understand that a consumer credit report or criminal records check may be necessary prior to my employment. If such reports are required, I understand that, in compliance with federal law, the company will provide me with a written notice regarding the use of these reports and will obtain a separate written authorization from me to consent to these reports. I also understand that a poor credit history or conviction will not automatically result in disqualification from employment.

In compliance with federal law, all persons hired will be required to identify and eligibility to work in the United States and to complete the required employment eligibility verification document form upon hire.

PART 2: Background Check/Motor Vehicle Record Authorization Form

Applicant Information

Address History

Current Address

Previous Address

Previous Address

The information contained in this application is correct and to the best of my knowledge. I hereby authorize Primary Grounds and its designated agents and representatives to conduct a comprehensive review of my background causing a consumer report and/or an investigative consumer report to be generated for employment purposes. I understand that the scope of the consumer report/investigative consumer report may include, but is not limited to the following areas: verification of social security number, current and previous residences, employment history, education background, character references, drug testing, civil and criminal history records from any criminal justice agency in any or all federal, state, county jurisdictions, driving records, birth records, and any other public records.

I further authorize an individual, company, firm, corporation, or public agency (including the Social Security Administration and law enforcement agencies) to divulge an and all information, verbal or written, pertaining to me, to Primary Grounds or its agents. I further authorize the complete release of any records or data pertaining to me which the individual, company, firm, corporation, or public agency may have, to include information or data received from other sources.

I hereby release Primary Grounds, the Social Security Administration, and its agents, officials, representatives, or assigned agencies, including officers, employees, or related personnel both individually and collectively from any and all liability for damages of whatever kind, which may, at any time, result to me, my heirs, family, or associates because of compliance with this authorization and request to release.