Employment Application

Applicant Information

First Name *

MI

Last Name *

Address *

City *

State *

Zip *

If your most recent address for 5+ years was different than the above, list it below.

Previous Address

City

State

Zip

SSN *

Driver's License Number *

DL State

Issued

Expires

Email *

Phone *

DOB *

Position Applying For *

Date Available *

Desired Salary/Hourly Wage *

Are you a citizen of the U.S.? *

If no, are you authorized to work in the U.S.? *

Have you ever worked for this company? *

If yes, when?

Are you willing to relocate? *

Do you speak and understand English? *

Can you read English? *

If you are under 18, can you provide required proof of eligibility to work? *

Have you ever filled out an application with us before? *

If yes, date

Do any friends or relatives work here? *

If yes, for whom

Are you currently employed? *

Means of transportation to work *

Have you ever been discharged or asked to resign? *

If yes, please explain *

Trainings or certifications

How did you hear about us?

Please answer:

Can you lift over 50lbs? *

Climb a ladder? *

Any disability we would need to accommodate? *

Can you drive in the dark? *

Stand/walk/sit for long periods without issues? *

Able to understand driving directions easily? *

Do you have allergies? *

If yes, would they hinder job responsibilities? *

If yes, please explain

Military Service

Are you a Veteran? *

Branch

From

To

Rank at Discharge

Type of Discharge

If other than honorable, explain

References

Business (leave blank if none)

Personal (required: at least 2)

Previous Employment

Please start with your most recent employer.

Special Skills, Training, Etc.

What special skills or experience would make you a good candidate?

Why do you want to work for us? What do you expect if hired?

List any training or licenses not previously mentioned

Potato/sugar beet hauling in last 20 years? If so, when and for whom?

If you have no work history listed through to current, why have you been out of work?

Were you referred by anyone? *

If yes, whom?

Experience Rating

Rate your experience (1=None ... 5=Expert). If you don’t know what something is, select 1 (None).

Item	1	2	3	4	5
Modern Harvester
Modern Chopper
Modern Baler
Modern Tractor
Modern Sprayer
Modern Spreader
Modern 9 & 10 Speed Trans
Diesel Trucks
Sugar Beets
Cattle
Corn
CB Radios
John Deere GPS: RTK/SF2
CASE IH GPS
Side Dump Trailer
End Dump Trailer
Heavy Equipment (Dozer)

Disclaimer and Signature

All information provided in this application (and/or any other accompanying or required documents) is true and complete to the best of my knowledge. Any false or misleading statements may remove me from further consideration or result in termination if employed.

By submitting this application, I authorize verification of information provided and agree to comply with company policies if hired.

I agree to the disclaimer above *

Signature (typed name) *

Date *

When you click Submit Application, your application will be sent for review.