Employment Application Form

Name:*

First NameMiddle NameLast Name
Birthdate:*

MonthDayYear
Home Phone Number:

Area CodePhone Number
Cell Phone Number:*

Area CodePhone Number
E-mail Address:
Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
How were you referred to us?*

Walk-InEmployeeFacebookInstagramOther
Which position are you applying for?*

Field Trip Worker - Must be available Weekday MorningsConcessionsCashier/Farm MarketWagon Driver (must be 18 years of age)Grounds Maintenance Crew
Availability

When can you work?*

	Monday	Tuesday	Wednesday	Thursday	Friday	Saturday	Sunday
From
To

Education

Please list the school you most recently attended
School Name

Street Address

CityState / Province

Postal / Zip Code
Date Completed
Job Skills & Training
Describe your skills:
Training or Certifications:
Employment History

Please list your last 3 places of employment, starting with the most recent
Employment 1
Name of Company
Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number

Area CodePhone Number
Supervisor
Reason for Leaving
Employment 2
Name of Company
Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number

Area CodePhone Number
Supervisor
Years Employed
Reason for Leaving
Employment 3
Name of Company
Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number

Area CodePhone Number
Supervisor
Date Started:

MonthDayYear
Date
Date Started:

MonthDayYear
Date
Reason for Leaving
Personal References

Please list three (3) references that are familiar with your character, personality, & NOT related to you.
Reference 1
Name:*

First NameLast Name
Phone Number*

Area CodePhone Number
Years Known:*
Nature of Relationship:*
Teacher, Youth Leader, Preacher, Etc.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Reference 2
Name:*

First NameLast Name
Phone Number*

Area CodePhone Number
Years Known:*
Nature of Relationship:*
Teacher, Youth Leader, Preacher, Etc.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Reference 3
Name:*

First NameLast Name
Phone Number*

Area CodePhone Number
Years Known:*
Nature of Relationship:*
Teacher, Youth Leader, Preacher, Etc.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
We may ask for a drug test and criminal background check, can you pass both? If no, please explain. *
By submitting this application, I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in termination of employment.
Should be Empty:

Availability

Education

Job Skills & Training

Employment History

Employment 1

Employment 2

Employment 3

Personal References

Reference 1

Reference 2

Reference 3