South Employment App

Please fill out all information below. Once submitted please allow 1-2 business days for reply.

- Grainland Cooperative Team

APPLICANT INFORMATION
Last Name
First Name
M.I.
Date
Street Address
City
State
Zip Code
Phone
Email
Date Available
Desired Salary
Elevator or Scale or Both
Location Minier
Emden
Armington
Are you a United States Citizen? Yes
No
If no, are you authorized to work in the U.S. Yes
No
Have you ever worked for this company? Yes
No
If so, when?
Have you ever been convicted of a felony? Yes
No
If yes, explain
____________________________________________
EDUCATION
High School
Address
Dates
Did you graduate? Yes
No
College
Address
Dates
Did you graduate? Yes
No
Other
Address
Dates
Did you graduate? Yes
No
____________________________________________
PREVIOUS EMPLOYMENT
Company
Phone
Address
Supervisor
Job Title
Starting Salary
Ending Salary
Responsibilities
Dates
Reason for leaving
May we contact your previous supervisor for a reference? Yes
No
____________________________________________
DISCLAIMER AND SIGNATURE
I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.
Signature *
Date *
____________________________________________
EMPLOYEE AVAILABILITY SHEET
Hours During Harvest: 7am-9pm
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
* Required field