Participa en E-Verify Este Empleador

Este Empleador
Participa en E-Verify
restringir o influenciar la selección de los documentos que sean
Este empleador le proporcionará a la Administración del Seguro
presentados para ser utilizados en el Formulario I-9.
Social (SSA), y si es necesario, al Departamento de Seguridad
Nacional (DHS), información obtenida
A fin de poder determinar si la
del Formulario I-9 correspondiente a
documentación del Formulario I-9 es
cada empleado recién contratado con el
valida o no, este empleador utiliza la
propósito de confirmar la autorización de
La Ley Federal le exige a
herramienta de selección fotográfica de
trabajo.
E-Verify para comparar la fotografía que
todos los empleadores
aparece en algunas de las tarjetas de
IMPORTANTE: En dado caso que el gobierno
que verifiquen la identidad y
residente y autorizaciones de empleo, con
no pueda confirmar si está usted autorizado
elegibilidad de empleo
las fotografías oficiales del Servicio de
para trabajar, este empleador está obligado
de toda persona contratada
Inmigración y Ciudadanía de los Estados
a proporcionarle las instrucciones por escrito
Unidos (USCIS).
y darle la oportunidad a que se ponga en
para trabajar en
contacto con la oficina del SSA y, o el DHS
los Estados Unidos.
Si usted cree que su empleador ha violado
antes de tomar una determinación adversa
sus responsabilidades bajo este programa,
en contra suya, inclusive despedirlo.
o ha discriminado en contra suya durante el proceso de verificación
debido a su lugar de origen o condición de ciudadanía, favor ponerse
Los empleadores no pueden utilizar E-Verify con el propósito de
en contacto con la Oficina de Asesoría Especial llamando al 1-800realizar una preselección de aspirantes a empleo o para hacer
255-7688 (TDD: 1-800-237-2515).
nuevas verificaciones de los empleados actuales, y no deben
A V I S O:
Para mayor información sobre E-Verify, favor ponerse
en contacto con la oficina del DHS llamando al:
1-888-464-4218
SI USTED TIENE DERECHO A TRABAJAR,
no deje que nadie se lo quite.
Si usted tiene el derecho a
trabajar legalmente en los Estados
Unidos, existen leyes que lo
protege contra la discriminación
en el trabajo.
Usted debe saber que:
 En la mayoría de los casos, los
empleadores no pueden negarle un
empleo o despedirlo debido a su país
de origen o estatus migratorio, o
negarse a aceptar sus documentos
válidos y legales.
 Los empleadores no pueden
rechazar documentos por que
tienen una fecha de vencimiento
futura.

Los empleadores no pueden
despedirlo debido a E-Verify, sin
darle una oportunidad de resolver el
problema.
 En la mayoría de los casos, los
empleadores no pueden exigir
que usted sea ciudadano
estadounidense o residente legal
permanente.
Si usted se ha encontrado en alguna
de estas situaciones, contacte a la
Oficina del Consejero Especial
(OSC).
Para ayuda en su propio idioma:
Teléfono: 1-800-255-7688 o
202-616-5594
Para las personas con discapacidad
auditiva:
TTY 1-800-237-2515 o
202-616-5525
Departamento de Justicia de EE.UU.
División de Derechos Civiles
E-mail: [email protected]
O escriba a:
U.S. Department of Justice - CRT
Office of Special Counsel- NYA
950 Pennsylvania Avenue, NW
Washington, DC 20530
Oficina del Consejero Especial Para
Prácticas Injustas en el Empleo
Relacionadas a Inmigración
www.justice.gov/crt/about/osc
This Organization
Participates in E-Verify
This SWA will provide the Social Security Administration (SSA) and, if necessary, the Department
of Homeland Security (DHS), with information
from each applicant’s Form I-9 to confirm work
authorization.
If you believe that your SWA
has violated its responsibilities
under this program or has
Federal law requires
discriminated against you
all employers
during the verification process
to verify the identity and
employment eligibility
based upon your national origin
of all persons hired to work
or citizenship status, please call
in the United States.
the Office of Special Counsel
for Immigration Related Unfair
Employment
Practices
at
1-800-255-7688 (TDD: 1-800-237-2515).
N O T I C E:
IMPORTANT: If the Government
cannot confirm that you are
authorized to work, this SWA is
required to provide you written
instructions and an opportunity
to contact SSA and/or DHS before
taking adverse action against
you, including terminating your
employment.
Employment Verification.
SWA and employers may not use E-Verify to reverify current employees and may not limit or
influence the choice of documents presented for
use on the Form I-9.
Done.
For more information on E-Verify,
please contact DHS at:
1-888-464-4218
The E-Verify logo and mark are registered trademarks of Department of Homeland Security. Commercial sale of this poster is strictly prohibited.
M-780 (rev. 12/2010)
IF YOU HAVE THE RIGHT TO WORK,
Don’t let anyone take it away.
If you have the legal right to
work in the United States, there are
laws to protect you against
discrimination in the workplace.

You should know that –



In most cases, employers cannot
deny you a job or fire you because
of your national origin or
citizenship status or refuse to
accept your legally acceptable
documents.
Employers cannot reject documents
because they have a future
expiration date.
Employers cannot terminate you
because of E-Verify without giving
you an opportunity to resolve the
problem.
In most cases, employers cannot
require you to be a U.S. citizen or
a lawful permanent resident.
If any of these things have
happened to you, contact the
Office of Special Counsel (OSC).
For assistance in your own language:
Phone: 1-800-255-7688 or
(202) 616-5594
For the hearing impaired:
TTY 1-800-237-2515 or
(202) 616-5525
U.S. Department of Justice
Civil Rights Division
Office of Special Counsel for
Immigration-Related Unfair
Employment Practices
E-mail: [email protected]
Or write to:
U.S. Department of Justice – CRT
Office of Special Counsel – NYA
950 Pennsylvania Ave., NW
Washington, DC 20530
www.justice.gov/crt/about/osc
4240 S. Coddington Ave.
Lincoln, NE 68522
Phone: (402) 489-6712
Fax: (402) 488-0202
4420 Lucile Dr.
Lincoln, NE 68516
Phone: (402) 489-6543
Fax: (402) 488-9013
Application for Employment
Position Desired
Landscape Design
Landscape Crew Leader
Landscape Crew Member
Landscape Maintenance
Nursery Production
Customer Service
Sales
Office
Name:
Last
First
Middle Initial
Current Address:
Street
City
If the above address is not permanent, please give a permanent mailing address:
Telephone:
State
Zip
Cell #:
Driver's License Number:
Is your license currently suspended or revoked?
Yes
No
If any, what convictions for moving violations have you received within the past three years?
(Be honest, the insurance company will verify)
Have you been convicted of a felony?
Yes
(Be honest, the insurance company will verify)
Are you available for full time work (including weekends if necessary)?
No
Yes
No
If No, what hours can we rely on you to work?
When would you be available to begin work:
Are you at least 18 years of age?
Yes
Can you show proof of age upon hire?
No
Yes
No
I have read the job description and understand the requirements needed to perform the job:
After reading the job description, is there any basis on which you would not be able to perform the essential
functions of this position?
Yes
No
If yes, please explain:
How were you referred to this position?
(please specify name of newspaper/publication or person whom you were referred by)
Yes
No
Application for Employment
Education
Please list all schools attended:
High school:
Name & Location of School
# of years attended
Graduated y/n
College or University:
Name & Location of School
# of years attended
Graduated y/n
Other Training:
Name & Location of School
# of years attended
Graduated y/n
List any and all persons willing to provide personal and/or professional references
(name & phone number)
1
2
3
4
I authorize investigation of all statements contained in this application. I understand that misrepresentation
or omission of facts called for is cause for dismissal and that my employment is dependent on truthful answers
to the foregoing inquiries.
Nebraska Nursery & Color Gardens is formally committed to providing equal employment opportunities and
will not discriminate against any employee or applicant because of race, color, religion, sex, age, national
origin, disability and marital or veteran status.
In consideration of my possible employment, I agree to conform to the rules and regulations of NN&CG and
my employment compensation can be terminated with or without casue and with or without notice, at any
time, at the option of either the company or myself. I understand that my employment with the company is
not governed by any express or implied contract of employment, either written or oral.
Date:
Signature:
Application for Employment
Please give an accurate and complete account of your past full-time and
part-time employment record, starting with your most recent employer.
Company Name
Supervisor/Contact
Phone Number
Address
Start Date
End Date
Name of Occupied Position
Starting Wage
Ending Wage
Additional Comments
Reason for Leaving
Company Name
Supervisor/Contact
Phone Number
Address
Start Date
End Date
Name of Occupied Position
Starting Wage
Ending Wage
Additional Comments
Reason for Leaving
Company Name
Supervisor/Contact
Phone Number
Address
Start Date
End Date
Name of Occupied Position
Starting Wage
Ending Wage
Additional Comments
Reason for Leaving
Company Name
Supervisor/Contact
Phone Number
Address
Start Date
End Date
Name of Occupied Position
Starting Wage
Ending Wage
Additional Comments
Reason for Leaving
May we contact the previous employers for references?
Indicate those which you do not want us to contact & the reason:
Yes
Do you have any lifiting limitations?
Yes
Some positions may require lifting equipment weighing 100 pounds.
Do you have the ability to lift equipment weighing 100 pounds?
No
Please explain any lifting limitations
No
Yes
No
Application for Employment
Experience Questionnaire
Name:
Date:
Please rank (using the scale below) your proficiency in the following areas below. Please be honest when
answering these questions, you will be tested in the various areas in order to become Certified.
Rating Scale:
1= Not Confident
Task/Equipment
Bobcat operations
Bobcat auger
Bobcat pinchers
Loading/unloading of bobcat
Transportation of bobcat
Mini tracked loader (ditchwitch)
Loading/unloading of mini tracked loader
Transportation of mini tracked loader
Small to medium utility tractors
Manual transmission pickups
Automatic transmission pickups
Vehicle maintenance
Gooseneck trailer hookup
Pulling gooseneck trailer
Trailer loading/unloading
Backing up trailers
Dump truck operation
Dump truck loading/unloading
Water trucks
Sod skimmer
Bed edger
Tiller
String trimmer
Chain saw
Pole saw
Ball cart
Backpack Sprayer
Vibratory Packer
Tape measure
String level
Transit
Mowing
Pruning perennials, shrubs & trees
2=Somewhat Confident
Operating
3=Confident
Maintaining
Safety
4=Very Confident
Teaching
Application for Employment
Experience Questionnaire
Please rank (using the scale below) your proficiency in the following areas below. Please be honest when
answering these questions, you will be tested in the various areas in order to become Certified.
Rating Scale:
1= Not Confident
Task/Equipment
B&B handling/planting
Container handling/planting
Installing edging
Installing weed barrier
Landscape installation
Landscape evaluations
Pond installation
Pond troubleshooting
Pumps
Irrigation systems installation
Irrigation systems troubleshooting
Hardscape installation
Concrete installation
Construction principles and practices
Fencing and or deck installation
Mulching
Installing rock
Boulder installation and or placement
Berm installation
Firepit installation
Drainage systems installation
Staking trees
Watering nursery stock
Welding
Mechanic/small engine repair
Nursery stock production
Reading blue prints
Drafting blue prints
Cash register operations
Computer skills
Operating large commercial mowers
Operating tractors and farm equipment
Tree trimming
Chemical application
Excavation
Grading
Sod installation
2=Somewhat Confident
Operating
3=Confident
Maintaining
Safety
4=Very Confident
Teaching
Application for Employment
**For Office Use Only**
Employment Interview
Interviewers Name:
Position Interviewing:
1st Interview
Date:
Department:
2nd Interview
3rd Interview
Experience
Motivation
Background not relevant to job requiremnt
Background somewhat relevant to job requirement
Acceptable background and experience
Strong background and experience
Excellent background and experience
Job Knowledge
No interest, apathetic, indifferent
Questionable interest in position
True desire to work
Solid interest; asked questions
Excellent motivation & desire to work
Composure
Nervous, fidgety and ill at ease
Strained, is easily tired
Average composure
Positive; appears to handle stress well
Exceptionally well composed
None pertaining to this position
Considerable training required
Basic, but capable of learning on the job
Very capable, little training needed
Well versed, able to handle position w/o training
Communication
Appearance
Very untidy
Below standard
Acceptable
Above average
Outstanding
Very little; communication poor
Attempts communication but does fair job at best
Acceptable communication and fluency
Communicates well and to the point
Excellent communication; extremely fluent
This applicant is:
A strong candidate
A possible candidate
Type of work applicant seems most qualified for:
Landscape Design
Landscape Crew Leader
Landscape Crew Member
Landscape Maintenance
Notes:
Nursery Production
Customer Service
Sales
Office
Of no further interest
Hired
Wage
Starting Date
Probationary Period
Seasonal
FT/PT