Personal Information

First Name*:

Middle Initial: (required)

Last Name*:

Street Address:

City:

State:
---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming

Zip:

Home Phone:

Cell Phone:

Are you at least 18 years old?:
YesNo

Date of Birth:

Do you have a valid Drivers License?:
YesNo

Drivers License Class:

Drivers License State:
---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming

Have you ever applied for or held a job with Jacobsen Tree Experts?:
NoYes, applied.Yes, held a job

If held a job when and what position?:

What type of work will you accept?:
Full-timeSeasonal/temp

Are you available to work overtime and weekends?:
YesNo

What type of work are you applying for?:
GroundlaborerTrimmer

Salary/Wage Desired:

per:
houryear

Employment History

Give your past employment record starting with your present or last employer (past three jobs held). Include military experience if applicable.

Company Name:

Company Phone:

Company Address:

Company City:

Company State:
---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming

Dates of employment from:

Dates of employment to:

Job Title:

Brief description of job duties:

Company Name:

Company Phone:

Company Address:

Company City:

Company State:
---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming

Dates of employment from:

Dates of employment to:

Job Title:

Brief description of job duties:

Company Name:

Company Phone:

Company Address:

Company City:

Company State:
---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming

Dates of employment from:

Dates of employment to:

Job Title:

Brief description of job duties:

Education

Name of High School:

Complete if you graduated:

Degree or Certificate Recieved:

Complete if you DID NOT graduate:

Last Grade Completed:

Name of Technical School or College:

Major:

Did you graduate?:
YesNo

References

List three non-related personal references.

Name:

Home Telephone Number:

Years Known:

Street Address:

City:

State:
---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming

How do you know this person?:

Name:

Home Telephone Number:

Years Known:

Street Address:

City:

State:
---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming

How do you know this person?:

Name:

Home Telephone Number:

Years Known:

Street Address:

City:

State:
---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming

How do you know this person?:

Skills Checklist

Check all boxes for which you have experience:

Production Skills

Tree ClimbingChipperStump GrinderBucket TruckChainsawBrush SawPole SawSprayingRoping

Other skills?:

Do you have experience with tree work?:
YesNo

If yes, please describe additional training, experience and number of years of experience:

Are you trained in line clearance tree trimming?
YesNo

If yes, When?:

By whom?:

Driving Skills

Do you possess a valid Commercial Driver's License?
YesNo

State:

Number:

Check all items that apply:

Automatic transmissionTwo-speed rear axleTruck and chipper combinationManual multi-speed transmissionOne-ton truckBucket truckTwo-ton truck

Ability to Perform Essential Functions of the Job: All positions are physically demanding. Entry-level employees in these positions are expected, within a reasonable time after they commence employment, to be able to perform tree work. This includes, but is not limited to, climbing trees and removing limbs using various hand and power tools on a continual basis during an eight to twelve hour shift; removing and disposing of tree limbs using various mechanized tools, which can require lifting and carrying from 50-100 pound loads. Are you physically able to safely perform these job duties with or without a reasonable accommodation?
YesNo

Have you ever had any sickness, disease or injury that would affect your ability to perform any work duties of any kind?
YesNo

Applicant Agreement

Read carefully before submitting. By pressing the submit button below you agree to the following statements.

I certify that the statements and information furnished by me in this application are true and correct and I understand that falsification of such statements or information will result in withdrawal of the employment offer, or immediate dismissal.

I authorize investigation of all statements contained herein and the references provided, and all information concerning my previous employment.

I authorize investigation of my motor vehicle record.

In consideration of my employment, I agree to conform to the rules, regulations and policies of Jacobsen Tree Experts, Inc.; which may require me to submit to any tests or examinations including drug testing and/or a medical examination.

I understand and agree that, if hired, my employment at will and I may be terminated at any time without prior notice and without cause.