APPLICATION FOR EMPLOYMENT
Application Date:
Date Avail:
Last
First
MI
Full Name:
Street
City
State
Zip
Address:
Home Phone:
Cell Phone:
Other:
Email:
Are you authorized to work in the United States?
Yes
No
Visa Classification:
Position Applying for:
Salary Desired:
When are you available to start?
Do you have a valid driver license?
Yes
No
Are you able to lift at least 20lbs?
Yes
No
Are you able to lift and squat?
Yes
No
Are you able to do repetitive bending/twisting?
Yes
No
Do you have allergies to Pollen, Bee stings, Insect bites or any allergies?
If yes, please explain:
Yes
No
Do you have any medical or physical conditions that may restrict you from doing any physical labor as defined in your position/job description?
If yes, please explain:
Yes
No
List any friends or relatives (and relationship) working for Global Ag Services:
Education and Specialized Training
Level
School Name & City
Field of Study
Completed
Degree
High School:
Yes
No
College:
Yes
No
Other:
Yes
No
Employment Skills
Skill
List of skill and level of knowlegde
# of Years acquired/Expiration date
Special licenses/certificates:
Trades:
Heavy Equipment/Farm Equipment:
Software Programs:
Office/Business Machines:
Please list any agriculture-field knowledge/work experiences:
Work Experience
1.
Name of Employer:
Supervisor/Contact Info:
Date Start:
Date End:
Position Title and Job Duties:
Reason for leaving (be specific):
2.
Name of Employer:
Supervisor/Contact Info:
Date Start:
Date End:
Position Title and Job Duties:
Reason for leaving (be specific):
Please list two (2) references not related to you:
1.
Name:
Phone:
Years Known:
Address:
Company:
Position:
2.
Name:
Phone:
Years Known:
Address:
Company:
Position:
Signed:
Dated:
