The Elegant Farmer
4737735254000-594360-205740 The Elegant FarmerEmployment Application TESTRESULTS00 The Elegant FarmerEmployment Application TESTRESULTSAll qualified applicants will be considered for employment without discrimination based on race, creed, gender, age, marital status, national origin, disability or veteran status.PERSONALLast Name First MiddleDate of this applicationStreet AddressHome PhoneCity, State, ZIPCell PhoneHave you ever applied for employment with us?___ Yes ___ No If Yes, month and year___________How long at present address?Position you are applying for:Wage/Salary Desired___ Full-time ____ Part-time ____ Weekends onlyHow many hours per week are you available? _____Are you 18 years or older? ____Yes ____NoAre you involved in any pending criminal charge allegations? _____Yes _____NoHave you been convicted of a crime in the past ten years, excluding misdemeanors and summary offenses, which has not been annulled, expunged, or sealed by the court? _____ Yes _____ No If “Yes”, describe in full.Answering yes to either of these questions does not automatically disqualify your application.List the names of relatives and friends working for us.Why do you want to work for us? What interested you in working for the Elegant Farmer?When will you be available to begin work?Are you legally eligible for employment in the United States? _____ Yes _____ NoAre there any job duties that you would be unable to perform?Do you have transportation to and from work?_____ Yes _____ NoEDUCATIONType of SchoolName & location of SchoolCourse of StudyNumber of years completedDid you Graduate?Degree, Certificate, License, or DiplomaHigh SchoolCollegeOtherOther special training or skills (languages, machine operation, administrative, etc.)Page 1 of 2444817510541000EMPLOYMENT HISTORYPlease give accurate, complete full-time and part-time employment record. Start with your present or most recent employer.1Company NamePhone ( )AddressDates Employed – (give month and year)From ToName of SupervisorStarting PayEnding PayYour Job Title and the type of duties you performedReason for LeavingMay we contact? ____Yes ____No2Company NamePhone ( )AddressDates Employed – (give month and year)From ToName of SupervisorStarting PayEnding PayYour Job Title and the type of duties you performedReason for LeavingMay we contact? ____Yes ____No3Company NamePhone ( )AddressDates Employed – (give month and year)From ToName of SupervisorStarting PayEnding PayYour Job Title and the type of duties you performedReason for LeavingMay we contact? ____Yes ____NoW O R K A V A I L I A B I L I T Y – List the times that you are available to work each day. Monday Tuesday Wednesday Thursday Friday Saturday SundayFROM TOSIGNATUREPLEASE READ BEFORE SIGNINGI understand that, if employed, employment is at will, and may be terminated by the employer or employee at any time for any reason, with or without cause, and with or without notice. I authorize the Elegant Farmer, Inc. to perform any necessary reference and background checks, and agree to indemnify and hold harmless The Elegant Farmer, Inc., any former employers, and all parties providing information relevant to my employment history. I certify that the information on this application is true, correct, and complete, and understand that failure to answer any questions truthfully, giving false or misleading information, and/or failing to disclose relevant information may be grounds for refusal of employment or, if employed, immediate termination of employment. I agree to a drug test if considered for employment.Date____________________ Signature___________________________________________________________________ ................
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