Application for Employment

Farmer Dave’s

Field Team Members
Note:

You can put N/A if not applicable.

Name*
Present Address*
Phone
Cell Phone*
E-mail*
Are you 18 years old or older?*
YES
NO
Who referred you to us?
Are you related to anybody working here? (If so, who?)
If offered a position, when can you start?*
How many hours per week do you want to work?*
What days and hours are you available to work?*
Days Starting TimeEnding Time
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
If you are a student, what are your available working hours when school starts?
Is there anything going on in your life, currently or coming up, that would interfere with your ability to be at work at the times stated in the above schedules?*
YES
NO
If yes, please describe fully
Are you currently working?*
YES
NO
If so, where?
Education*
Name and Location of SchoolNumber of years completedDid you graduate?Subjects studied
High School
College
Other Training Programs
Subjects of special study or research work (or include a list of horticultural classes taken)
Other activities (you are not required to list activities that indicate a race, creed, color, national origin, or religious affiliation)
Volunteer work
Have you ever been convicted of a felony?*
YES
NO
If yes, please explain:
Work Experience and Former Employers – please fill out completely. Attach an additional sheet if needed.*
Start DateEnd DateName and Address of EmployerPositionReason for leaving
1
2
3
References – Please list at least three references that are not related to you:*
NamePhone NumberRelationshipYears Acquainted
1
2
3
Do you have a valid driver’s license?*
YES
NO
If so, what class:
Describe any previous experience you have had with farming, plants and produce:
Describe any previous experience you have had working with the public:
Please attach a resume if available. Resume attached?
YES
NO
Do you have any physical conditions which may limit your ability to perform the job for which you are being considered?*
YES
NO
If yes, please explain:

I certify that the facts contained in this application are true and complete to the best of my knowledge and I understand that, if employed, falsified statements shall be grounds for dismissal.

I authorize investigation of all statements contained herein and the references listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release all parties from liability for any damage that may result from furnishing same to Farmer Dave’s.

I authorize release of credit reports from any credit agency. I authorize Farmer Dave’s to conduct a background investigation of me if I am chosen for the final round of the selection process.

I understand that Farmer Dave’s has a handbook that applies to certain positions, and that I may be bound by the policies in that book. If I am hired for a position to which the handbook applies, I will read and accept these policies before accepting employment.

I understand and agree that, if hired, my employment is for no definite period and may be terminated by Farmer Dave’s or by me at any time with or without cause or prior notice, regardless of the date of payment of my wages and salary.

Signature:
Date