Careers, Job Openings | Binghamton Agway

Application for Employment

Join our team! Please apply by filling out our application and attaching your resume.
Name *

First Name Last Name
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Phone Number *

Area Code Phone Number
Email *
myemail@myemailaddress.com
How did you hear about us?
Friend, Employee, Newspaper, Online, Indeed...
Location you are applying for *
Please select the location you would prefer or applying for.
Availability & Restrictions *

Full Time Part Time
Have you applied to this Company before? *

Yes No
If Yes - did you interview?

Yes No
Are you capable of performing the essential functions of the position - which includes the ability to lift up to 50lbs and stand up to 8 hours?

Yes No
Are you 18 years of age or older? *

Yes No
Are you legally authorized for employment in this country? *

Yes No
Have you served in the Military?

Yes No
Education
Please fill out the Education portion of this Form to the best of your ability.
High School Name
High School Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
High School Diploma?

Yes No
If currently in school, please list your class schedule
College Name
College Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
College Degree?

Yes No
If currently in college please list your class schedule
Any Other Training or Certifications?
Briefly describe the type of training and any certificates, if applicable
Previous Employment
Please fill out this section starting with your last Employer to the best of your knowledge, if applicable. If never employed, please type N/A in each field
Name of Previous - Employer 1 *
First, Last or Company Name
Position Held - Employer 1 *
Employment Dates - Employer 1 *
From (Month/Day/Year) to (Month/Day/Year)
Reasons for leaving Employer 1
Briefly describe your reason(s) for leaving
Name of Previous - Employer 2
First, Last or Company Name
Position Held - Employer 2
Employment Dates - Employer 2
From (Month/Day/Year) to (Month/Day/Year)
Reason for leaving Employer 2
Briefly describe your reason(s) for leaving
Name of Previous - Employer 3
First, Last or Company Name
Position Held - Employer 3
Employment Dates - Employer 3
From (Month/Day/Year) to (Month/Day/Year)
Reason for leaving Employer 3
Briefly describe your reason(s) for leaving
Application Process

Qualified candidates please apply by filling out our application and attaching your resume. Your background will be reviewed by our Human Resources Manager who is responsible for our talent attraction and career development activities at Choice Pet and you will be contacted by phone to set up an interview. We do not accept walk in interviews.
Resume Upload

Please upload your CV/Resume or any other relevant file here. Max file size: 8 Mbs.
Cancel of
Certification and Signature
I hereby certify that the information provided on this application and all
information provided throughout the pre-employment process is accurate,
complete and true. I understand that failure to provide information which is
accurate, complete and true may result in disqualification from further
employment consideration or, if employed, may result in my dismissal. I agree to have official transcripts of all my undergraduate and graduate studies submitted when requested by the employer and hereby authorize Choice Pet and its agents to contact references and former employers relative to my application for employment. Finally, I understand that employment, if offered, is contingent upon proof of employability under the requirement of the Immigration Reform Control Act (IRCA).

Choice Pet is an affirmative action/equal opportunity employer.
I Certify to the above statement. *

Yes No
Signature *

Clear
Date *

Month Day Year
Date
Please verify that you are human *
Should be Empty:

Application for Employment