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Please fill out the following information to be enrolled in our organization. Please ensure it is accurately filled and in case there is technical issues, email the webmaster at

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General Information you should know

  • Can you show proof of your eligibility to work in the United States? Yes / No
  • Are you the minimum working age of 18-years-old or older? Yes / No
  • VERIGREEN INC facilities are smoke-free environments. Can you adhere to this policy? Yes / No
  • Are you a VERIGREEN INC volunteer? “Yes, Now” / “Yes, in the Past” / No
  • Have you ever been employed before by VERIGREEN INC? Yes / No
  • If yes, specify job held / dates of employment___________________________ /___________________________
  • Do you have friends or relatives already employed by VERIGREEN INC? Yes / No If yes, list them and indicate relationship: 1_______________________ 2______________________________ 3 __________________________________
  • If you answer a yes to any of the following three questions, please explain in the space provided on page 4:
      Do you have any physical, mental or medical conditions that would interfere with your ability? Yes / No
      To perform the job for which you are applying? Yes / No
      Are you currently charged with or have you ever been convicted of any crime, or has your driver's license been suspended? Yes / No
      . Have you ever been suspended or discharged from employment? Yes / No
      _____________________________________________________If yes please state the reasons