Job Application -

Job Application Form

Name

Date of application

Street Address

Town & Zip Code

Home Phone Number

Cell Phone Number

Your email

Applying For

Wage Requested, per hour

Are you under 18?

If yes, are you under 16?

Do you have reliable transportation?
YesNo

Do you attend school?
YesNo

If yes, where?

Previous Employment Reference

First Employer

Name

Company/Relationship

Employer Phone Number

Second Employer

Name

Company/Relationship

Employer Phone Number

Are you looking for:
Temporary Work (ie Summer or holiday workPart TimeFull Time

What date are you available to start?

How many hours a week would you like to work?

Availability: Please specify all days and times you will be available on a regular basis.

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

Johnson’s Corner Farm, LLC is an equal opportunity employer. This application will not be used for limiting or excluding any applicant from consideration for employment on a basis prohibited by local, state, or federal law. Applicants requiring reasonable accommodation in the application and/or interview process should notify a representative of the organization. Johnson’s Corner Farm, LLC is an at will employer.

I certify that information contained in this application is true and complete. I understand that false information may be grounds for not hiring me or for immediate termination of employment at any point in the future if I am hired. I authorize the verification of any or all information listed above.

Print Name

Date