Careers, Job Openings | Binghamton Agway

Scruggs Farm, Lawn & Garden is an equal opportunity employer. Scruggs Farm, Lawn & Garden does not discriminate in employment with regard to race, color, religion, national origin, citizenship status, ancestry, age, sex (including sexual harassment), sexual orientation, marital status, physical or mental disability, military status or unfavorable discharge from military service or any other characteristic protected by law.

Name*

First NameLast Name

Phone Number*

Area CodePhone Number

Email*

example@example.com

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Date Available to Start *

Date

Desired Salary*

Position Applying For*

Are You A Citizen of the United States?*

YesNo

If No, Are You Authorized To Work In The U.S?

YesNo

Have You Ever Worked For This Company?*

YesNo

If Yes, When?

Have You Ever Been Convicted Of A Felony?*

YesNo

If Yes, Please Explain:

Education
Please fill out the Education portion of this Form to the best of your ability.

High School Name

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

From

Date

To

Date

Did You Graduate?

YesNo

Type of Diploma Acquired

College Name

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

From

Date

To

Date

Did You Graduate?

YesNo

Type of Degree Acquired

Other Education

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

From

Date

To

Date

Did You Graduate?

YesNo

Type of Degree or Certificate Acquired

References
Please fill out this section with 3 professional references.

Reference 1 Name*

First NameLast Name

Relationship*

Company*

Reference 1 Phone Number*

Area CodePhone Number

Reference 1 Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Reference 2 Name*

First NameLast Name

Relationship*

Company*

Reference 2 Phone Number*

Area CodePhone Number

Reference 2 Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Reference 3 Name*

First NameLast Name

Relationship*

Company*

Reference 3 Phone Number*

Area CodePhone Number

Reference 3 Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Previous Employment
Please fill out this section starting with your last Employer to the best of your knowledge

Company 1*

Phone Number*

Please enter a valid phone number.Format: (000) 000-0000.

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Suprevisor's Name*

Job Title*

Starting Salary ($)

Ending Salary ($)

Responsibilities*

From

To

Reason For Leaving*

May We Contact Your Previous Supervisor For A Reference?*

YesNo

Company 2*

Phone Number*

Please enter a valid phone number.Format: (000) 000-0000.

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Suprevisor's Name*

Job Title*

Starting Salary ($)

Ending Salary ($)

Responsibilities*

From

To

Reason For Leaving*

May We Contact Your Previous Supervisor For A Reference?*

YesNo

Company 3*

Phone Number*

Please enter a valid phone number.Format: (000) 000-0000.

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Suprevisor's Name*

Job Title*

Starting Salary ($)

Ending Salary ($)

Responsibilities*

From

To

Reason For Leaving*

May We Contact Your Previous Supervisor For A Reference?*

YesNo

Military Service

Branch

From

To

Rank At Discharge

Type Of Discharge

If Other Than Honorable, Explain:

Disclaimers and Signature

Please read carefully before signing.

I understand that neither the completion of this application nor any other part of my consideration for employment establishes any obligation for Scruggs Farm, Lawn & Garden to hire me. If I am hired, I understand that either Scruggs Farm, Lawn & Garden or I can terminate my employment at any time and for any reason, with or without cause and without prior notice. I understand that no representative of Scruggs Farm, Lawn & Garden has the authority to make any assurance to the contrary.

I attest with my signature below that I have given to Scruggs Farm, Lawn & Garden true and complete information on this application. No requested information has been concealed. I authorize Scruggs Farm, Lawn & Garden to contact references provided for employment reference checks. If any information I have provided is untrue, or if I have concealed material information, I understand that this will constitute cause for the denial of employment or immediate dismissal.

Signature*

Date*

Date

Please verify that you are human*

Scruggs Employment Application