Employment

Fields marked with an asterisk (*) are required.

Position Applied for*

Name*

Address*

Phone Number*

Email*

Are you an American Citizen?*
YesNo

Are you at Least 18 years of Age?*
YesNo

How did you hear about us? *

Have you ever been convicted of a felony?*
YesNo

Explain below, if Yes*

Are you applying for Full Time or Part Time?*
Full-timePart-time

What hours are you available?*

Day	Mon	Tue	Wed	Thu	Fri	Sat	Sun
AM	Y	Y	Y	Y	Y	Y	Y
PM	Y	Y	Y	Y	Y	Y	Y

Educational History*

Name of School	Years Attended	Highest Degree Earned

Please explain why you are qualified for the position you are applying for*

Job History*

Company Name	Job Title	Time Employed	May we Contact?	Supervisor Name and Number
			Yes
			Yes
			Yes

References*

Name	Phone Number	Years Known	Relationship

What does cannabis mean to you?*

Attach any other documents such as resumes, cover letters and additional references below.

Attachment 1

Attachment 2

Attachment 3

*PLEASE READ CAREFULLY BEFORE AGREEING*

I hereby certify that all of the information provided by me in this application (or any other accompanying or required documents) is correct, accurate and complete to the best of my knowledge. I understand that the falsification, misrepresentation or omission of any facts in said documents will be cause for denial of employment or immediate termination of employment regardless of the timing or circumstances of discovery.

I understand that submission of an application does not guarantee an employment opportunity. I further understand that, should an offer of employment be extended by Reynold Greenleaf & Associates, LLC (hereinafter referred to as RGA) that such employment with RGA is at-will, with no specified duration and may be terminated by either RGA or myself at any time, with or without cause or notice. I understand that none of the documents, policies, procedures, actions, statements of RGA or its representatives used during the employment process is deemed a contract of employment real or implied. I understand that no representative of RGA except the President has the authority to enter into any agreement guaranteeing any conditions of employment or any agreement contrary to the foregoing statements and that any such agreements must be made in writing and signed by the President of RGA.

In consideration for employment with RGA if employed, I agree to conform to the rules, regulations, policies and procedures of RGA at all times and understand that such obedience is a condition of employment. I understand that due to the nature of RGA business, attendance and punctuality are considered essential requirements of every job at RGA and that poor attendance or tardiness will result in disciplinary action including but not limited to termination.

I hereby authorize any and all schools, former employers, references, courts and any others who have information about me to provide such information to RGA and/or any of its representatives, agents or vendors.

I hereby authorize RGA to pull any investigative consumer report from a reporting agency for the purpose of evaluating employment history. This report may contain information regarding my past education, past employment, general reputation, and criminal record from record sources. I understand that I have a right to request additional disclosures regarding the nature and scope of the investigation.

I understand that this application is considered current for one year (twelve months). If I wish to be considered for employment after this period, I must fill out and submit a new application.

Applicant Acknowledgement and Authorization*
I ACKNOWLEDGE THAT I HAVE READ, UNDERSTOOD AND AGREE TO THE ABOVE STATEMENTS

Name and number of person completing this form if other than applicant