SECTION 1 — Personal Information
Please provide your work experience and availability details to determine your suitability for seasonal agricultural jobs.
Full Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
WhatsApp Number
Email Address
*
example@example.com
Current Country of Residence
*
Country of Citizenship
*
SECTION 2 — Current U.S. Status & Transfer Information
Current U.S. Status & Transfer Information
Are you currently in the USA and interested in a transfer?
*
Yes
No
Are you currently working for another U.S. employer?
*
Yes
No
Employer name (if known)
First Name
Last Name
Farm name
Employer City and State
Reason for seeking transfer
Please Select
Season ending
Not enough hours
Relocation
Better opportunity
Poor housing
Other
When does your current employment end?
-
Month
-
Day
Year
Date
SECTION 3 — Passport & Work Authorization
Passport and visa details for work authorization review.
Do you have a valid passport?
*
Yes
No
Passport Expiration Date
-
Month
-
Day
Year
Date
Passport upload (Optional)
Upload a File
Drag and drop files here
Choose a file
Cancel
of
Have you worked in the U.S. before?
*
Yes
No
If yes, what visa type?
H-2A
H-2B
J-1
TN
Other
Visa upload
Upload a File
Drag and drop files here
Choose a file
Cancel
of
Visa Expiration Date (if applicable)
-
Month
-
Day
Year
Date
SECTION 4 — Agricultural Experience
Have you worked in agriculture before?
*
Yes
No
Years of agricultural experience
*
Less than 1 year
1–2 years
3–5 years
5+ years
Type of agricultural work experience
*
Field Crop Work
Orchard Work
Vineyard Work
Nursery Work
Greenhouse Work
Livestock Work
Dairy Work
General Farm Labor
Which equipment can you confidently operate alone?
*
Tractor
Skid steer
Loader
Sprayer
Seeder
Combine
Hay equipment
Forklift
What specific farm tasks have you performed?
Have you supervised other workers before?
*
Yes
No
Have you completed a full agricultural season before?
*
Yes
No
Have you ever left a farm job early?
*
Yes
No
Why did you leave early?
SECTION 5 — Work Conditions & Preferences
Are you available for seasonal agricultural work?
*
Yes
No
Are you able to travel for work?
*
Yes
No
Are you traveling?
*
With spouse
With family
Alone
Additional housing needs or notes
SECTION 6 — Availability
Available Start Date
*
-
Month
-
Day
Year
Date
SECTION 7 — Signature & Agreement
Today's Date
/
Month
/
Day
Year
Date
Signature
Full Name - Country of Citizenship
Submit Inquiry
Submit Inquiry
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