NON-DOT APPLICATION FOR EMPLOYMENT

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Date* This field is required.
Date
Month
Day
Year
10
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Hour
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Minutes
PM
AM
PM
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Name* This field is required.
First Name
Middle Name
Last Name
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Date of Birth* This field is required.
Date
Month
Day
Year
4
Address* This field is required.
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
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Phone Number* This field is required.Primary Phone
Area Code
Phone Number
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Phone NumberSecondary Phone
Area Code
Phone Number
7
If hired, can you furnish proof that you are eligible to work in the United States?* This field is required.
YESNO
8
Are you 18 years of age or older?* This field is required.
YESNO
9
Have you ever been employed by James Valley Grain LLC?* This field is required.
YESNO
10
EDUCATIONAL HISTORY* This field is required.
HIGH SCHOOL
COLLEGE OR UNIVERSITY
GRADUATE SCHOOL
TECHNICAL, BUSINESS OR VOCATIONAL TRAINING
DID NOT GRADUATE
11
If applying for a position which will require driving, please provide:Driver's License #, Class and State
12
Job opening for which you are applying?* This field is required.If Available
General Labor
Truck Driver
Probe / Office Assistant
Other
13
Location you are most interested in working at?
Oakes East Terminal
Oakes West Terminal
Verona Terminal
Berlin Elevator
Any Location
14
WORK HISTORY - Enter in your past seven (3) years of employment, starting with your most current employer. Failure to provide complete information may result in rejection of your application.* This field is required.(1)
Company Name
City
State
Phone Number
START DATE - END DATE
Job Title
Final Wage
PRIMARY JOB RESPONSIBILITIES & REASON FOR LEAVING
15
WORK HISTORY - Enter in your past seven (3) years of employment, starting with your most current employer. Failure to provide complete information may result in rejection of your application.(2)
Company Name
City
State
Phone Number
START DATE - END DATE
Job Title
Final Wage
PRIMARY JOB RESPONSIBILITIES & REASON FOR LEAVING
16
WORK HISTORY - Enter in your past seven (3) years of employment, starting with your most current employer. Failure to provide complete information may result in rejection of your application.(3)
Company Name
City
State
Phone Number
START DATE - END DATE
Job Title
Final Wage
PRIMARY JOB RESPONSIBILITIES & REASON FOR LEAVING
17
REFERENCES* This field is required.Please list at two or three work-related references. Current or past supervisors/managers are strongly preferred. Do not include relatives. (1)
Name
Work Relationship
Job Title
E-mail Address
Telephone (with area code):
Company Name, City, State
18
REFERENCESPlease list at two or three work-related references. Current or past supervisors/managers are strongly preferred. Do not include relatives. (2)
Name
Work Relationship
Job Title
E-mail Address
Telephone (with area code):
Company Name, City, State
19
REFERENCESPlease list at two or three work-related references. Current or past supervisors/managers are strongly preferred. Do not include relatives. (3)
Name
Work Relationship
Job Title
E-mail Address
Telephone (with area code):
Company Name, City, State
20
Do You Agree to the Following?* This field is required.Drug testing of applicants The company requires individuals working on their premises to take and pass a drug test before they can begin work. Offers o f employment for positions will be contingent upon the applicant taking and passing a drug test. Applicants who do not desire to take a drug test may indicate their refusal at the time of the conditional offer of employment.
YESNO
21
Comments / Other Info you would like to share with James Valley Grain Optional
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Ok
22
Optional Doc Upload if Needed
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Signature* This field is required.
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