EMPLOYMENT APPLICATION Date:

  Oct/3/2022

Personal Information
Name (Last) (First) (Middle) DO NOT WRITE IN THIS SECTION
Morales Malichi Nathaniel
Home Address City State Zip
2013 superior Avenue Springfield Ohio 45505
Home Telephone Business Telephone May we contact you at work? ___
✔ Yes ___ No

937-926-4778
Position Applying For:
Days and Day Mon Tues Wed Thurs Fri Sat Sun
Internship position in landscaping hours
10:3 10:3
available to From
Date Available: Are you interested in (check all that apply) 0am 0am
work:
11:0 11:0
Full-time Part-time Temporary ✔ Summer 0pm 0 pm
To
Are you willing to relocate? Yes ✔ No Are you willing to travel? ✔ Yes No
Are you 18 or older? Yes ✔ No What percent N/A %
How did you hear of this opening?
Listing of jobs in the newspaper

Ever convicted of a crime? ____No

✔ ____ Yes Have you ever been involved in a shortage or
misunderstanding with respect to funds, merchandise, or
Explain:
inventory, etc.? ✔ No Yes Explain:

Education
Type of Degree/Area of No. of
Name and Location of School
School Study GPA Years Graduated
Attended
✔
High school 4. 2021-cur
High School Urbana High School 00 Yes No
Diploma rent
College Yes No

Graduate
Yes No
School
Business or
Yes No
Trade School
Other Yes No

List any professional license or registration you hold:

____________________________________________________________________________________________________

Special Skills
Computer software knowledge:
Other:

Military History
Military Branch of Service: Technical Specialization: Rank When Leaving:
Employment History
POSITION HELD LIST MAJOR SALARY REASON FOR
DATES NAME AND ADDRESS OF EMPLOYER
AND DUTIES OR LEAVING
SUPERVISOR WAGES
From: Name Your Job Title Starting
mo. / yr.
Address City State
To:

mo. / yr. Supervisor Final

Phone

From: Name Your Job Title Starting

mo. / yr.
Address City State
To:

mo. / yr. Supervisor Final

Phone

From: Name Your Job Title Starting

mo. / yr.
Address City State
To:

mo. / yr. Supervisor Final

Phone

References
Phone No. of Years
Name Occupation/Title Address Number Known

1. Toni Overholser Clark State Mentor 937.328.8070 2 years

2. Mallory Zahrich FFA Advisor 1/2 year

3. Steve Wilhelm FFA Advisor 1 1/2 years

Goals
Please write your short and long term goals.
_______________________________________________________________________________________
Grow and learn many skills and trades that can be used in growing as part of the company.
_______________________________________________________________________________________
___________________________________________________________________________Applicant's
Statement
I understand that, with my authorization, an investigation may be made whereby information obtained regarding my character, previous employment, general
reputation, educational background, credit record and/or criminal history. I hereby certify that all answers in this application are true and to the best of my
knowledge and belief, it being understood that any material false statements or omissions of facts in this application will be sufficient cause for discharge. I
will abide by and conform to all policies, rules and procedures of the company.

Malichi Morales
Applicant's Signature _____________________________________ Oct/3/2022
Date __________________