Name (required)*
First Name
Middle Name
Last Name
Date of Birth (Optional)
Are you at least 18 years old? (Required)*
YesNo
You must be at least 18 years old to work for this State. Lifting of workers 18 years of age and younger in the State
Address (Optional)
Street Address
Address Line 2
City
State / Province
Postal / Zip Code
I would like to be considered for the following positions:
Do you have previous experience in the cannabis industry? If yes, explain:
Phone (Optional)
Email (Optional)
Date Available (Optional)
Desired Salary (Optional)
Which days/hours are you available to work? (Required)
Are you a citizen of the United States? (Required)
[radio* us-citizen class:radio-option "Yes" "No"]
If No, are you authorized to work in the U.S.?
Have you ever been convicted of a felony? (Optional)
If yes, explain:
High School
Address
From
To
Did you graduate?
Diploma
College
Degree
Other education
Full Name
Relationship
Company
Phone
Job Title
Supervisor
Starting Salary ($)
Ending Salary ($)
Responsibilities
Reason for Leaving
May we contact your previous supervisor for a reference?
Disclaimer and Signature
I certify that my answers are true and complete to the best of my knowledge.
If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.
I agree to the terms and conditions set forth above.
Signature
Are you over 21 ?