Careers, Job Openings | Binghamton Agway

Today's Date*

Date

Your Name*

First NameLast Name

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Cell Phone Number*

Area CodePhone Number

Home Phone Number*

Area CodePhone Number

Your Email Address*

example@example.com

Position You Are Applying For*

Status*

Full-timePart-time

If you are under 18-years of age, can you provide required proof of your eligibility to work?*

YesNoN/A

Do any of your friends or relatives work here?*

YesNo

If Yes, Please State Name & Relationship

Can You Work Until 8:00 PM?*

YesNo

Can You Work Saturdays & Sunday?*

YesNo

Can You Work Holidays?*

YesNo

Are You Currently Employed?*

YesNo

1. Employer Name*

1. Employer Address *

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

1. Employer Phone Number*

Please enter a valid phone number.

1. Employed Dates:*

MM/YYYY - MM/YYYY

1. Job Title*

1. Work/Duties Performed*

1. Supervisor's Name*

1. May We Contact Your Supervisor?*

YesNo

1. Reason For Leaving*

2. Employer Name*

2. Employer Address *

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

2. Employer Phone Number*

Please enter a valid phone number.

2. Employed Dates:*

MM/YYYY - MM/YYYY

2. Job Title*

2. Work/Duties Performed*

2. Supervisor's Name*

2. May We Contact Your Supervisor?*

YesNo

2. Reason For Leaving*

3. Employer Name*

3. Employer Address *

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

3. Employer Phone Number*

Please enter a valid phone number.

3. Employed Dates:*

MM/YYYY - MM/YYYY

3. Job Title*

3. Work/Duties Performed*

3. Supervisor's Name*

3. May We Contact Your Supervisor?*

YesNo

3. Reason For Leaving*

Please Explain Any Gaps In Your Employment History*

Describe Any Specialized Training, Experience And/Or Skills As It Relates To The Position You Are Applying For*

Other Qualifications*

High School Name*

High School Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Did You Graduate High School?*

YesNo

College/University Name*

College/University Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Did You Graduate College/University?*

YesNo

Other:

Name or Type

Describe Any Educational Experience That You Consider Applicable To The Position You Are Applying For*

1. Reference Name*

First NameLast Name

1. Reference Title*

1. Reference Email Address*

example@example.com

1. Reference Phone Number*

Please enter a valid phone number.

2. Reference Name*

First NameLast Name

2. Reference Title*

2. Reference Email Address*

example@example.com

2. Reference Phone Number*

Please enter a valid phone number.

3. Reference Name*

First NameLast Name

3. Reference Title*

3. Reference Email Address*

example@example.com

3. Reference Phone Number*

Please enter a valid phone number.

I certify the answers given herein are true and complete to the best of my ability. I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision. This application for employment shall be considered active for a period of time not to exceed 45 days. Any applicant wishing to be considered for employment beyond this time period should inquire as to whether or not applications are being accepted at that time. I hereby understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with this organization is of an "at will" nature, which means the Employee may resign at any time and the Employer may discharge the Employee at any time, with or without cause. In the event of employment, I understand false or misleading information in my application or interview(s) may result in discharge. I also understand I am required to abide by all rules and regulations of this Employer.

Signature Of Applicant*

Please Type Your Name As It Appears Above*

First NameMiddle NameLast Name

Date*

Date

Signature Of Applicant*

Please Type Your Name As It Appears Above*

First NameMiddle NameLast Name

Date*

Date

1. What Did You Like The Most About Your Last Job? What Did You Like The Least?*

2. Why Do You Want The Particular Position You Are Applying For?*

3. What Are The Strengths And Weaknesses You Feel You Bring To The Position You Are Applying For? *

1. Which Drill Bit Is Larger?*

5/163/8

2. Which Drill Bit Is Larger?*

1/83/16

3. Which Drill Bit Is Larger?*

1/27/16

4. Which Drill Bit Is Larger?*

1/21/4

5. Which Drill Bit Is Larger?*

3/813/32

6. Which Drill Bit Is Larger?*

3/325/64

7. Which Drill Bit Is Smaller?*

9/647/32

8. Which Drill Bit Is Smaller?*

15/647/32

1. ADD: 4.75 + 3.79 =*

Please type your answer.

2. ADD: 4.98 + 7.59 + .98 =*

Please type your answer.

3. ADD: 1.98 + 42.21 + 8.43 =*

Please type your answer.

4. ADD: 32.01 + 9.49 + 17.27 + 27.37 =*

Please type your answer.

5. ADD: .24 + .97 + .08 + 1.29 + .36 =*

Please type your answer.

6. ADD: 56.97 + 6.57 + 58.32 + 1.78 + 64.89 =*

Please type your answer.

7. SUBTRACT: 1.49 - .93 =*

Please type your answer.

8. SUBTRACT: 119.87 - 29.78 =*

Please type your answer.

9. SUBTRACT: 4.98 - 1.29 =*

Please type your answer.

10. MULTIPLY: 17.59 x .03 =*

Please type your answer.

11. MULTIPLY: 9.87 x .04 =*

Please type your answer.

12. MULTIPLY: 12.98 x 5 =*

Please type your answer.

13. MULTIPLY: 32.41 x 7 =*

Please type your answer.

Round up to the nearest cent.

1. Regular Price $15.49 x 10% DISCOUNT =*

Type amount to be tendered.

2. Regular Price $21.17 x 10% DISCOUNT =*

Type amount to be tendered.

3. A Case Of Cleaner Contains 24 Bottles At $1.39 Each. The Customer Wants A Full Case. How Many Bottles Will The Customer Be Charged For?*

Round your answer to the next whole cent, please.

1-A. 3 For .79?*

1-B. 3 For .89*

1-C. 5 For .99?*

2. How Many SQUARE FEET In A 20' x 80' House?*

3. How Many Of The Five Items Listed Are Exact Duplicates Of Each Other? #7362, #62735, #527182, #918264, #1628357, #7363, #63737, #527182 *

Please Verify That You Are Human*

Employment Application

WORK HISTORY

EDUCATION

REFERENCES

APPLICANT'S STATEMENT

DRUG & ALCOHOL DISCLOSURE

ESSAY PORTION

MATH SKILLS PART 1

MATH SKILLS PART 2

DETERMINE THE AMOUNT A CUSTOMER WILL PAY AFTER THE DISCOUNT IS APPLIED