Heglar Creek Farms - Employment Application

- please fill out this form completely -
     
 
We have employment opportunities on the dairy, farm and sod businesses.
Please indicate which you are applying for -
 
 
 
     
EMPLOYEE DATA
 
 
Last Name
Social Security Number
 
 
First Name
Home Phone Number
-
 
 
Middle Name
Mobile Phone Number
-
 
 
Date of Birth
,
Sex:
           
 
Email
 
           
 
Address
 
 
City
State
ZIP
 
 
How long at this address?
How long at prior address?
 

 


 
Have you worked for Heglar Creek Farms or Raft River Sod before?
 
 
Names of friends or relatives who presently work for Heglar Creek Farms or Raft River Sod
 
           
 
PERSONALREFERENCES
 
           
 
Name:
   
     
Home Phone Number
-
 
     
Work Phone Number
-
 
 
Address
 
 
City

State
ZIP
 
           
 

 
 
BUSINESS REFERENCES
 
         
 
Name:
   
     
Home Phone Number
-
 
     
Work Phone Number
-
 
 
Address
 
 
City

State
ZIP
 
           
 
 
           
 
Name:
   
     
Home Phone Number
-
 
     
Work Phone Number
-
 
 
Address
 
 
City

State
ZIP
 
           
 
 
           
 
Name:
   
     
Home Phone Number
-
 
     
Work Phone Number
-
 
 
Address:
 
 
City:
State
ZIP
 
       
     
 
 
 
POSITION DESIRED
 
           
 
Position
 
  Date you can start
,
 
 
Employed now?
   
 
May we contact your current employer?
   
         
 
Please check all shifts you are available to work: Day Shift Night Shift
 
 
 
         
 
EDUCATIONAL BACKGROUND
 
 
List the last three (3) schools you attended, beginning with the most recent.
 
     
 
Name - School - 1
Years completed
 
 
Major or Degree
Graduate?
       
 
 
 
Name - School - 2
Years completed
 
 
Major or Degree
Graduate?
 
       
 
 
 
Name - School - 3
Years completed
 
 
Major or Degree
Graduate?
 
       
           
 
EMPLOPYMENT HISTORY
 
 
List your last three (3) employers, starting with the most recent.
 
           
 
Company 1
Phone Number
-
 
 
Address
Supervisor
 
 
 
 
Company 2
Phone Number
-
 
 
Address
Supervisor
 
 
 
 
Company 3
Phone Number
-
 
 
Address
Supervisor
 
           
 
GENERAL
 
           
 
List any foreign languages you speak and your level of familiarity.
 
      (select all that apply)  
 
Language 1
Speak some Speak Fluently Read Write
 
 
Language 2
Speak some Speak Fluently Read Write
 
 
Language 3
Speak some Speak Fluently Read Write
 
           
 
SECURITY
 
           
 
Have you ever been bonded?
 
 
Please explain -
 
 
Have you been convicted of a felony?
 
 
If yes, explain, stating when,
and what it was:

(this will not necessarily exclude you from consideration)
 
   
           
 
AUTHORIZATION
 
 

I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for dismissal.