Miller Plant Farm Employment Application

Our policy is to provide equal empoyment opportunity to all qualified persons without regard to race, creed, color, religious belief, sex, age, national origin, ancestry, physical or mental disability or veteran status.
Date of Application Date of Application * / MM / DD YYYY
Name Name * First Last
Address Address *
Street Address Address Line 2 City State Zip Code Country
Email *
Phone Phone * - ### - ### ####
Alternate Phone Alternate Phone - ### - ### ####
Are you a U.S. citizen or otherwise authorized to work in the U.S. on an unrestricted basis? (You may be required to provide documentation) *

Are you a U.S. citizen or otherwise authorized to work in the U.S. on an unrestricted basis? (You may be required to provide documentation) Yes No
Have you ever been convicted of a felony? (This will not necessarily affect your application) *

Have you ever been convicted of a felony? (This will not necessarily affect your application) Yes No
If yes, please describe conditions:
What type work are you interested in? *
When can you start? When can you start? / MM / DD YYYY
Are you looking for full-time employment? *

Are you looking for full-time employment? Yes No
If no, what daytime hours are you available?
Are you willing to work evenings?

Are you willing to work evenings? Yes No
Are you willing to work weekends?

Are you willing to work weekends? Yes No
Education
High School (Name of School/Year Graduated)
College (Name of College/Major?Degree Obtained)
Other Training
What other skills, qualities, or experience would you bring to Miller Plant Farm that we should consider?
Employment History
1. Company Name
Address Address
Street Address Address Line 2 City State Zip Code Country
Phone Phone - ### - ### ####
May we contact?

May we contact? Yes No
Responsibilities:
Reason for leaving:
2. Company Name
Address Address
Street Address Address Line 2 City State Zip Code Country
Phone Phone - ### - ### ####
May we contact?

May we contact? Yes No
Responsibilities:
Reason for leaving:
I certify that the facts set forth in this application for employment are true and complete to the best of my knowledge. I understand that if I am employed, false statements on this application shall be considered suffiecient cause for dismissal. This company is hereby authorized to make any investigations of my prior education and employment history.

I understand that employment at this company is "at will" which means that either I or this company can terminate the employment relationship at any time, with or without prior notice and for any reason not prohibited by statute. All employment is continued on that basis.
Draw your signature into the box below.

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.
Date Date / MM / DD YYYY

Miller Plant Farm Employment Application

Miller Plant Farm Employment Application

Our policy is to provide equal empoyment opportunity to all qualified persons without regard to race, creed, color, religious belief, sex, age, national origin, ancestry, physical or mental disability or veteran status.

Education

Employment History