Wheeler Brothers Grain Co - Employment Application

Contact Information

First Name

Last Name

Street Address

City

State

Zip Code

Home Phone

Work Phone

Cover Letter and Resume

Resume

Personal Information

Are you legally eligible to be employed in the United States? (proof will be required)

Yes

Are you at least 18 years or older? (If no, you may be required to provide authorization to work.)

Yes

Have you ever been convicted, pled guilty or no contest, or forfeited bond or bail for any crime other than traffic violations?

Yes

If yes, please explain. Conviction of a crime is not an automatic bar to employment. Factors such as the nature and gravity of the crime, the length of time that has passed since the conviction and/or completion of any sentence, and the nature of the job for which you have applied will be considered.

Have you ever worked for this Company before?

Yes

If Yes, please provide details (Where/When/Job Title):

Are you able to perform the essential functions of the job for which you are applying?

Yes

If no, please explains:

Employment Desired

Location Desired

Position Applied For

When would you be available to begin work?:

Type of employment desired:

Full-Time

Part-Time

Seasonal

Hourly rate/salary desired

Are you currently employed?

Yes

If so may we inquire of your present employer?:

Yes

If presently employed, why are you considering leaving?:

Education

School & Location

Did you graduate?

Yes

Degree Received

Subjects Studied/Major

School & Location

Did you graduate?

Yes

Degree Recevied

Subjects Studied/Major

School & Location

Did you graduate?

Yes

Degree Recevied

Subjects Studied/Major

Employment History

Employer 1

Employed From

Employed To

Employer Name

Employer Address

Employer Phone

Employer Email

Job Title

Supervisor Name & Title

May we contact?

Yes

Responsibilities

Reason for Leaving

Starting Salary

Ending Salary

Employer 2

Employed From

Employed To

Employer Name

Employer Phone

Employer Email

Job Title

Supervisor Name & Title

May we contact?

Yes

Responsibilities

Reason for Leaving

Starting Salary

Ending Salary

References

Reference 1 Name

Relationship

Phone Number

Reference 2 Name

Relationship

Phone Number

Reference 3 Name

Relationship

Phone Number

Authorization The facts set forth in this application and any supplemental information is true and complete to the best of my knowledge. I understand that, if employed, falsified statements on this application shall be considered sufficient cause for immediate discharge. I hereby authorize investigation of all statements contained herein and employers listed above to give you any and all information concerning my employment, and any pertinent information they may have, and release all parties from all liability for any damage that may result from furnishing same. I understand that neither the completion of this application nor any other part of my consideration for employment establishes any obligation for the company to hire me. If I am hired, I understand that either the company or I can terminate my employment at any time and for any reason, with or without cause and without prior notice. I understand that no representative of the company has the authority to make any assurance to the contrary. I understand that I am required to abide by all rules and regulations of the company.

Signature (Type Name)

Date

Required field

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