Application for Employment

First Name Middle Name Last Name Social Security # Telephone #

Nikolas Mackenzie Reece 616-970-2907
Permanent Address: Street City State Zip
703 S Greenvill W Dr Ste 7 Box 237 Greenvill MI 48838

STATEMENT OF POLICY: EMPLOYMENT WITH GREAT LAKES LANDSCAPE SUPPLY COMPANY IS BASED ON
INDIVIDUAL MERIT. EMPLOYMENT OPPORTUNITIES ARE OPEN TO ALL, WITHOUT REGARD TO RACE,
COLOR, SEX, AGE, MARITAL STATUS, HEIGHT, WEIGHT, RELIGION, NATIONAL ORIGIN, HANDICAP OR
VETERAN STATUS.

Instructions to Applicant: The careful and thoughtful completion of this application is an important step in our consideration of
individuals for employment. Therefore, you must complete the entire application. If you do not, you will not be considered for
employment. Your application must also specify the position you are applying for; stating that you will do “anything” is too indefinite
and will result in your application not being accepted by the Company.

Please be further advised that your application will go into our active file for 60 business days from the date of application. In order
for you to keep your application current it will be necessary for you to inform our personnel office in writing, prior to the expiration of
the 60 day period that you wish to remain on the Company’s active applicant list. If, at the end of the 60 day period, we have not
received written notice from you, your name will be taken off the active applicant list and you will not be considered for employment
when a vacancy occurs. Should you contact the Company after the 60 day period has expired, you will be treated as a new applicant.

The application provides information which enables us to determine whether an applicant has the interests, background and experience
to be given additional consideration for employment. In most cases, circumstances will prevent a preliminary interview; therefore, the
conscientious completion of this form is necessary inasmuch as it will supply much of the information normally covered in such a
session.

At the appropriate time you will be required to establish your citizenship or, if not a citizen, your eligibility for employment. Please
print in ink and use your own handwriting. Use the space on the last page to clarify any response or, if desired, tell us anything else
about yourself you believe relevant.

After you have read these instructions and prior to leaving the Company’s personnel office or facilities, please ask the personnel
person or manager any questions that you may have. He/she will be happy to answer them for you.

Position Applied for: Regular Temporary

Nursery Plant Handler & Maintenance Full-time Full-time

Part-time X Part-time
Date Available: Are you willing to work Are you currently on “Lay-off” Please provide email address if you have
evenings and weekends? status and subject to recall? one.
April 10th Nikreece2007@gmail.com
Yes X No Yes No X
Have you previously If Yes, when and for what position? Are you prevented for lawfully becoming employed in
submitted an application this country because of visa or immigration status?
to this company?
Yes No X
Yes No X

Proof of citizenship will be required upon employment.

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FORMER EMPLOYERS: List past employers starting with the most recent first. Attach additional sheets of paper or use space at
the end of the application if necessary.

Name Street Address Telephone #

North Kent Golf 11029 Stout Ave NE (616) 866-2659
Course
Supervisor City State Zip
Eric Shwab Rockford MI 49341
Starting Date Ending Date Starting Salary Ending Salary
April 15th October 25 9.87 9.87
Description of Job Duties and Responsibilities:
I would clean carts and help costumers when needed
Reason for Leaving: Are You Eligible for Rehire?
Seasonal job and looking for better pay Yes No
X

Name Street Address Telephone #

Supervisor City State Zip

Starting Date Ending Date Starting Salary Ending Salary

Description of Job Duties and Responsibilities:

Reason for Leaving: Are You Eligible for Rehire?

Yes No

Name Street Address Telephone #

Supervisor City State Zip

Starting Date Ending Date Starting Salary Ending Salary

Description of Job Duties and Responsibilities:

Reason for Leaving: Are You Eligible for Rehire?

Yes No

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 Name Street Address Telephone #

Supervisor City State Zip

Starting Date Ending Date Starting Salary Ending Salary

Description of Job Duties and Responsibilities:

Reason for Leaving: Are You Eligible for Rehire?

Yes No

Please explain all gaps in your employment, and, if applicable, why you were unemployed for a period in excess of one month from
It was winter and the golf course
the time you commenced your most recent job to the present__________________________________________________________
was not open for me to work at at
the time.

Should we expect to receive any “negative” comments from any of your previous employers? Yes No x

If “Yes,” explain why: _______________________________________________________________________________________

Have you ever been discharged, suspended, or asked to resign from employment? Yes No x

If “Yes,” explain why: _______________________________________________________________________________________

Have you ever been bonded? Yes No x

If “Yes,” When ________________________ For Whom __________________________________________________________

EDUCATION:

List below High School, College, and Graduate School attended or other formal, special technical education you have received.

Name Address # Of Degree GPA Major

Years

Cedar Springs High School 04 E Muskegon St 1.5 Still in high school 2.5 Still in high school

Please list any experience or license you have that may be helpful to the job you are applying for. _____________________________

___________________________________________________________________________________________________________

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Have you ever been convicted of a crime? (A: Yes” answer will not automatically disqualify you. We will examine the nature of the
crime, the date committed, and the relation of the crime to the job(s) for which you are applying.) Yes No x

If so, please explain:_____________________________________________________________________________________________________

Some French
What foreign languages do you speak? __________________________________________________________________________

U.S. Military or Naval Service __________________________________________________ Rank _______________________

Present Membership in National Guard or Reserves ________________________________________________________________

PERSONAL REFERENCES. Other then Relatives or Employers:

Name Address Telephone # Occupation Years

Acquainted

I verify that all of the information given on this application is true, accurate and complete. I understand and agree that any
falsification, misrepresentation, misleading statement, or omission of fact on either this Application or during the pre-hire process will
be sufficient reason for (1) my not being offered employment or (2) dismissal at any time from the service of the Company if
employed.

I authorize my former employers to provide the Company and information regarding my employment and medical records,
including and in addition to the above, and I release all parties from any liability for any damages which may result from furnishing
such information. I also agree to permit the Company to conduct substance abuse tests and any other background investigative
procedures it deems appropriate with respect to my application and, in the event of hire, while employed. I understand a consumer
report may be obtained from a consumer reporting agency in connection with this application and, if requested, will be informed of the
name and address of the agency. I understand and agree that my employment and compensation is for no definite period and may
regardless of the time and manner of payment of my wages and salary be terminated at any time by the Company, with or without
cause, and without any previous notice. I also understand an agree that the Company has the right to unilaterally modify and/or
terminate any policies, practices, procedures, and standards it has adopted or implemented, to the extent not limited by law. I
acknowledge that no Company employee or representative, other than its President, has either the power or authority to enter into any
agreement for employment for any specified period of time, or to make any representations or agreements contrary to any of the
foregoing, unless that agreement is in writing and signed by the President of the Company.

Nikolas Reece
________________________________________________________ 01/26/23
_____________________
Signature Date

FOR OFFICE USE ONLY

Work Location: Date of Hire: Federal:

Job Description: Employee # State:
EM Contact: Rate: City:
EM Contact # DOB: