APPLICATION FOR EMPLOYMENT This application is valid for 60 days from today’s date.
Date:___________________
__________________________________________________________________________________________________
Green Sense Farms considers applicants for all positions without regard to race, color, religion, creed, gender, national origin, age, disability, marital or veteran status, union affiliations, sexual orientation or any other legally protected status. All sections of this application must be completed to be considered for employment. (PLEASE PRINT)
Name:____________________________________________________________________________________ Last
First
Middle
Address:___________________________________________________________________________________ Street
City
State
Zip
_________________________________________________________________________________________ Telephone Number
Social Security Number
Position Applied For:
Hourly Rate/Salary Sought:
_____________________________________________
_____________________________________________
How Did you Learn About Us? Internet
Employment Agency
Friend
Walk In
Employee Referral
Job Fair
Green Sense Farms Website
Other
Other
Yes File Name: Application for Employment
Last Updated: 12.1.2015
Page 1 of 7
No
1. Are you over the age of 18?
2. Have you ever filed an application with Green Sense Farms before?
a. If yes, give dates:
_________________
3. Have you ever been employed by Green Sense Farms before?
a. If yes, give dates:
_________________
4. Are you currently employed?
5. If yes, may we contact your present employer?
6. Are you currently on “lay off” status and subject to recall?
7. Are you legally able to work able to work in the United States?
8. Can you travel if a job requires it?
9. Do you have a valid driver’s license?
10. Do you have a reliable means of transportation?
11. Have you been convicted of a felony within the last 7 years?
12. On what date will you be available for work?
_________________
GREEN SENSE FARMS IS AN EQUAL OPPORTUNITY EMPLOYER Employment Experience Start with your present or last job. Include any job-related military service assignments and volunteer activities. You may exclude organizations which indicate race, color, religion, gender, national origin, disabilities or other protected status. Employer Name:
Address:
Job Title:
Supervisor:
Date Employed From
Employer Name:
To
Telephone #:
Work Performed:
Hourly Rate/Salary Starting
Address:
Reason for Leaving:
Final
Telephone #:
APPLICATION FOR EMPLOYMENT Job Title:
Supervisor:
Date Employed From
To
Hourly Rate/Salary Starting
Employer Name:
Address:
Job Title:
Supervisor:
Date Employed From
To
Starting
Address:
Job Title:
Supervisor:
From
To
File Name: Application for Employment
Telephone #:
Work Performed:
Reason for Leaving:
Final
Telephone #:
Work Performed:
Hourly Rate/Salary Starting
Reason for Leaving:
Final
Hourly Rate/Salary
Employer Name:
Date Employed
Work Performed:
Reason for Leaving:
Final Last Updated: 12.1.2015
Page 3 of 7
GREEN SENSE FARMS IS AN EQUAL OPPORTUNITY EMPLOYER Education School
Name and Location of School
Course of Study
Years Completed
High School College Other
Describe any specialized training, apprenticeships, skills, job related or military training:
References
Name
Contact #
Relationship
Name
Contact #
Relationship
Name
Contact #
Relationship
Diploma/Degree
APPLICATION FOR EMPLOYMENT Name
Contact #
Relationship
I certify that answers given herein are true and complete to the best of my knowledge. I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision and release Green Sense Farms, LLC from any liability. This application for employment shall be considered active for a period of time not to exceed 60 days. Any applicant wishing to be considered for employment beyond this time period should inquire as to whether or not applications are being accepted at that time. I hereby understand and acknowledge that if hired, my employment relationship with Green Sense Farms, LLC is of an “at will” nature, which means that I may resign at any time and Green Sense Farms, LLC may discharge me at any time with or without cause. It is further understood that this “at will” employment relationship may not be changed by any written document or by conduct unless acknowledged in writing by an authorized executive of this organization. In the event of employment, I understand that false or misleading information given on my application or interview(s) may result in discharge. I understand also that I am required to abide by all rules and regulations of Green Sense Farms, LLC
___________________________________________________
_______________________
Signature of Application
Date
FOR PERSONNEL DEPARTMENT USE ONLY Arrange Interview
Yes
No
Date of Interview: ____________________________________
Remarks: __________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
File Name: Application for Employment
Last Updated: 12.1.2015
Page 5 of 7
Employed
Yes
No
Department:______________________
Date of Employment: ______________________________
Hourly Rate/Salary: _______________________________
Job Title:_________________________
Generic Notes Only:
BY:
DATE:
If Hired Please Provide The Following Information
Who do we contact in case of emergency:
Drivers License #:
Classification:
APPLICATION FOR EMPLOYMENT Birth Date:
File Name: Application for Employment
Married: Yes No
Last Updated: 12.1.2015
Dependants:
Page 7 of 7