CRI Job Application

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Application for employment

Application for Employment:

*Fields in red are required fields.

Date of Application: November 20, 2009

Attach your resume(one file): Attach another file:
* Position Applied For:
* Last Name:		* First Name:
Middle Name:		* Email Address:
* Street Address:		* City:
* County:		* State:
* Zip Code:
* Telephone Day:		* Telephone Evening:

If you are under 18, can you furnish a work permit?	Yes No
Have you ever been employed here before?	Yes No
Are you legally eligible for employment in this country? (Proof of U.S. citizenship or immigration status will be required upon employment.)	Yes No
Date Available for work:
Type of employment desired:	Full-Time Part-Time Temporary Seasonal Educational Co-op
Do you object to working on Saturdays and Sundays?	Yes No
Have you been convicted of a felony in the last seven(7) years? (Such conviction may be relevant if job related, but does not bar you from employment.)	Yes No
If Yes, Please explain :

Employment History

List your last three employers, assignments or volunteer activities, starting with the most recent.

From	To	Employer	Telephone
Job Title		Address
Immediate Supervisor and Title		Summarize the nature of work performed and job responsibilities
Reason for leaving		Hours Rate/Salary Start $ per Final $ per
From	To	Employer	Telephone
Job Title		Address
Immediate Supervisor and Title		Summarize the nature of work performed and job responsibilities
Reason for leaving		Hours Rate/Salary Start $ per Final $ per
From	To	Employer	Telephone
Job Title		Address
Immediate Supervisor and Title		Summarize the nature of work performed and job responsibilities
Reason for leaving		Hours Rate/Salary Start $ per Final $ per

Which of the above jobs did you like best?

Why?

Educational History

Name and location of school (write names and city)	Number of years	Did you graduate?	Dates (optional)	Nature of Course Taken or Degree	Approximate Grade Av.
High School

College

Other

Other

Favorite school subjects?			Subjects least liked?
What other additional education or business training have you had such as extension training, night school, correspondence school, business college, or company training?

Experience

Do you have a farm background?	Yes No	Dairy or Other?	How Many years?
Any other agricultural experience?	Yes No
Have you have any sales experience?	Yes No	What did you sell?

Additional Information

Make and year of vehicle(s) owned?
Driver's license number		State
Has your driver's license ever been suspended or revoked?		Yes No
Have you had a moving traffice violation within the past three years?		Yes No If yes, How Many?
Are you willing to relocate?		Yes No

It is understood and agreed upon that any misrepresentation by me in this application will be sufficient cause for cancellation of this application and/or separation from the employer's service if I have been employed. All employees are considered "employees at will" with no offer or guarantee of continued employment. Furthermore, I understand that just as I am free to resign at any time, the employer reserves the right to terminate my employment at any time, with or without cause and without prior notice. I understand that no representative of the employer has the authority to make any assurances to the contrary.

I give the employer the right to investigate all references and to secure additional information about me, if job related. I hereby release from liability the employer and its representatives for seeking such information and all other persons, corporations or organizations for furnishing such information.

Signature of Application: Date:

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