LOC Job Application

Name

First Name Last Name

E-mail

Phone Number

Area Code Phone Number

Street Address

Address Line 2

City

State

Zip Code

What job are you interested in? *

If referred to by someone, enter their first and last name:

In case of an emergency, please notify:

Name

First Name Last Name

Phone Number

Area Code Phone Number

If you are younger than 18, how old are you?

Do you have transportation to work?

Yes No

Have you ever been arrested?

Yes No

If yes, please explain:

Have you ever been convicted of a misdemeanor or felony?

Yes No

If yes, please explain:

What interests you about working for Lakeland Orchard & Cidery? What do you hope to gain from this experience?

We require a minimum of 15 hours of availability per week. Do you meet this minimum?

Yes No

High School

From

Date

To

Date

Did you graduate?

Yes No

Did you attend college?

Yes No

If yes, where?

Degree:

Employment 1

Company Name

Phone Number

Area Code Phone Number

Street Address

Address Line 2

City

State

Zipcode

Title/Job Responsibilities

From Date

Date

To Date

Date

Reason for leaving?

Employment 2

Company Name

Phone Number

Area Code Phone Number

Street Address

Address Line 2

City

State

Zipcode

Title/Job Responsibilities

From Date

Date

To Date

Date

Reason for leaving?

Reference 1

Name

First Name Last Name

Phone Number

Area Code Phone Number

Reference 2

Name

First Name Last Name

Phone Number

Area Code Phone Number

Reference 3

Name

First Name Last Name

Phone Number

Area Code Phone Number

"I certify that the facts contained in this application are true and complete to the best of my knowledge and understand that, if employed, falsified statements on this application shall be grounds for dismissal.

I authorize investigation of all statements contained within and the references and employers listed above to give you any and all information concerning my previous employment and any pertinent information they may have, personal or otherwise, and release the company from all liability for any damage that may result from utilization of such information."

Signature

Enter your name to sign

Date

Lakeland Orchard & Cidery - Job Application

General Information

Education

Previous Employment

References

Signature