Recruitment Application Form

Full Name*

First NameLast Name

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Phone Number*

E-mail*

example@example.com

Birth Date

MonthDayYear

Are you over the age of 18?*

YesNo

Are You a U.S. Citizen?*

YesNo

Have you ever been Convicted of a felony?*

YesNo

If Yes, Please explain:

Position Applying For*

Date You Can Start*

Date

Have You applied here before?*

YesNo

Are you willing to work weekends?*

YesNo

Can you travel if the job requires it?*

YesNo

How were you referred to us?

High School

Name of High School Attended

Number of Years Attended

Graduated?

YesNo

College

Name of College/University Attended

Number of Years Attended

Area of Study/Degree

Graduated?

YesNo

Graduate School

Name of Graduate School Attended

Number of Years Attended

Area of Study/Degree

Graduated?

YesNo

Trade School/Other

Name of Trade/Technical/Other School Attended

Number of Years Attended

Area of Study/Degree

Graduated?

YesNo

Skills

List any relevant skills

Qualifications

List any relevant certifications or qualifications

Current Employer

Name of Current Employer or NONE if not Employed

Position

Current Salary ($)

Reason for Leaving?

Start Date

Date

May We Contact?

YesNo

Previous Employer

Name of Previous Employer

Position

Previous Salary ($)

Reason for Leaving?

Start Date

Date

End Date

Date

Previous Employer

Name of Previous Employer

Position

Previous Salary ($)

Reason for Leaving?

Start Date

Date

End Date

Date

Reference 1

Name of Reference

Relationship

Years Acquainted

Phone Number

Please enter a valid phone number.

Email

example@example.com

Reference 2

Name of Reference

Relationship

Years Acquainted

Phone Number

Please enter a valid phone number.

Email

example@example.com

Reference 3

Name of Reference

Relationship

Years Acquainted

Email

example@example.com

Phone Number

Please enter a valid phone number.

Cover Letter

Resume

PLEASE READ CAREFULLY BEFORE SIGNING

I understand that any material misrepresentation, omission, or falsification of any information provided on this application, if discovered anytime during my employment, will be considered grounds for discharge.

I understand that neither the acceptance of this application, nor the granting of an interview creates, or is intended to create a contract or contract right between Mears and/or its subsidiaries and myself for the employment or any other benefit. No oral or written promise or guarantee of employment has been made, and I understand that no such promise or guarantee is binding upon Mears and/or its subsidiaries unless made in writing and signed by the President of the company or his designee. If an employment relationship is established, I agree to conform to the rules and regulations of Mears and/or its subsidiaries and recognize that my employment and compensation can be terminated with or without cause, and with or without notice, at any time, at the option of either the company or myself.

I hereby authorize the companies or persons named in the employment history portion of this application to furnish any information regarding me or my period of employment, whether or not it is in their records, personnel or otherwise, thereby releasing said companies or persons and Mears and/or its subsidiaries from all liability for damages whatsoever for issuing and obtaining this information.

This certifies that this application was completed by me, and that all entries on it, and information in it are true and complete to the best of my knowledge.

Date

Signature*

Mears Fertilizer Employment Application

Contact Information:

Employment Desired:

**Please complete the section below OR attach a resume to the bottom of this application. Incomplete applications, or those submitted without a resume, will not be considered for employment.

Education:

Skills/Qualifications:

Current Employment:

Previous Employment:

References:

Cover Letter & Resume (Optional):

Send Application: