General Employment – Autauga Farming Company

First Name

Middle Name

Last Name

Street Address

City

State

Zip Code

Telephone

Email Address

How did you hear about this job?

If hired, do you have a reliable means of transportation to get to work?

Minimum desired starting salary?

Are you at least 18 years old?

If the job you are applying for requires driving: Driver's License No.

State Issued and Expiration Date

Are you legally eligible for employment in the U.S.? Proof of U.S. Citizenship or immigration status will be required if hired.

Have you been convicted of a crime, other than a minor traffic violation, in the last ten years?

If yes, state the nature of the offense and disposition of the case. Include dates and places. (NOTE: The existence of a criminal record does not constitute an automatic bar to employment.)

Employment you are seeking: (Full-time, Part-time, Temporary)

What position(s) are you applying for?

Are you willing to work weekends?

Are you willing to work holidays?

Are you currently employed?

If hired, when would you be able to start?

Have you ever worked for us before?

If yes, name you used:

List any friends or relatives employed by this company:

Are you on layoff and subject to recall?

Have you ever been discharged or asked to resign from any position?

If yes, please explain:

How many days have you missed from work or school within the last year other than approved vacation, sick, or disability leave?

How many days have you been late to work or school within the last year other than approved vacation, sick, or disability leave?

Please describe:

Elementary

Name of School

Location

Graduated?

Secondary

Name of School

Location

Graduated or GED?

College

Name of School

Location

Graduated?

Degree and Major

Minor

Are you a veteran?

If yes, gives dates of service:

List any special skills or training:

1

Employer

Date Employed From

Date Employed To

Address

Telephone Number(s)

Job Title

Supervisor

Reason for Leaving

2

Employer

Date Employed From

Date Employed To

Address

Telephone Number(s)

Job Title

Supervisor

Reason for Leaving

3

Employer

Date Employed From

Date Employed To

Address

Telephone Number(s)

Job Title

Supervisor

Reason for Leaving

4

Employer

Date Employed From

Date Employed To

Address

Telephone Number(s)

Job Title

Supervisor

Reason for Leaving

May we contact all of the employers listed above?

If not, tell which one(s) you do not wish us to contact and why:

How many jobs have you had in the last five years not listed above?

Why are you seeking a new position at this time?

List any business-related outside interests and organization you are active in:

I authorize this company to make an investigation of all information contained in this employment application and I release all companies and corporations supplying such information. I understand any false answers, statements, or implications made by me on this application or other required documents shall be considered sufficient cause for denial of employment or discharge. Upon termination of my employment for whatever reason, I release this company from all liability for supplying any information concerning my employment to any potential employer. I authorize this company, if applicable, to request a copy of my credit report, motor vehicle driving record, and any other investigative report deemed necessary through various third party sources. As required by law, upon request within a reasonable period of time, I will be notified as to the nature and scope of such investigations. I hereby agree to submit to any drug/alcohol test required of me, whether prior to my employment or if employed with this company at any time thereafter. I understand and expressly agree that if employed by the company, storage areas provided for me (locker, desk, etc.) are open to investigation or search by the company without prior notice to me. I further understand this is an application for employment and that no employment contract is being offered. I understand that if I am employed, such employment is for an indefinite period of time and the company may change wages, benefits, and conditions at any time. My employment is at will. No individual within the company is authorized to change the employment-at-will status except an officer of the company, who may do so only in writing. I have read and understand the above.

Full Legal Name

Date

We are an Equal Opportunity Employer. All applicants are considered without regard to race, color, religion, disability, sex, national origin, age, or any other basis protected by federal, state, or local law. This employment application is active for 30 days. After this time period a separate employment application must be submitted in order to be considered for employment.

Employment

Available Position(s)

Job Description

Employment Application

Personal

Employment Data

Education and Training

Elementary

Secondary

College

Military Service

Work History

1

2

3

4

Affidavit