Employment Application | DixieMaze Farms

Applicant Details

Name *

First

Middle

Last

Date of Birth *

SSN: *

Email *

Cell Phone *

Alternate Phone *

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

If you are offered employment, when would you be available to begin work? *

The first day of the season is Sept. 24th.

Emergency Contact

Name of emergency contact *

First

Last

Cell Phone number of emergency contact *

Preferred Position

Did anyone refer you?

Yes
No

If yes, who?

Do you have any friends or family that work for us? *

Yes
No

If yes, who?

Have you applied to our company before? If yes, when? *

Are you willing to work any shift including nights and weekends? If no, state any limitations. *

Applicants skills: Select all that apply: *

If you do have First Aid experience please explain below.

Employment History

List your current or most recent employment first. List the last 3 jobs (including self-employment and military service) you've had, beginning with the most recent, list and explain any gaps. If you have none, put N/A.

Most recent Employer Name

Supervisor Name

First

Last

Work Address

Address Line 1

Address Line 2

City

State

Zip Code

Job Duties

Reason for leaving

Dates of Employment (mm/yy)

Work Experience #2

Employer Name

First

Last

Supervisor Name

First

Last

Work Address

Address Line 1

Address Line 2

City

State

Zip Code

Reason for leaving

Dates of employment (mm/yy)

Work Experience #3

Supervisor Name

First

Last

Employer Name

Work Address

Address Line 1

Address Line 2

City

State

Zip Code

Job Duties

Reason for leaving

Dates of employment (mm/yy)

Education and Training

What is your highest level of education? *

Military Service *

Yes
No

Branch and Training

References

List any two non-relatives who would be willing to provide a reference for you.

Name *

First

Last

Phone

Relationship *

Name *

First

Last

Phone

Relationship

If hired, what would your availability be(when can you work)? *

Please provide any other information that you believe should be considered.

Resume

Click or drag a file to this area to upload.

If you would like to provide a resume , please do that here.

I certify that the information provided on this application is truthful and accurate. I understand that providing false or misleading information will be basis for rejection of my application, or if employment commences, immediate termination. I authorize DixieMaze Farms LLC to contact former employers and educational organizations regarding my employment and education. I authorize my former employers and educational organizations to fully and freely communicate information regarding my previous employment, attendance, and grades. I authorize those persons designated as references to fully and and freely communicate information regarding my previous employment and education. If an employment relationship is created, I understand that unless I am offered a specific written contract of employment signed on behalf of the organization by its Human Resources Manager, the employment relationship will be "at-will". In other words, the relationship will be entirely voluntary in nature, and either I or my employer will be able to terminate the employment relationship at anytime and without cause. With appropriate notice, I will have the full and complete discretion to end the employment relationship when I choose and for reasons of my choice. Similarly, my employer will have the right. Moreover, no agent, representative, or employee of DixieMaze Farms LLC, except in a specific written contract of employment signed on behalf of the organization by its Human Resources Manager, has the power to alter or vary the voluntary nature of the employment relationship. *

BY TYPING OUT YOUR NAME ABOVE YOU ARE ELECTRONICALLY SIGNING THIS APPLICATION AND YOU ARE CONFIRMING THAT YOU HAVE CAREFULLY READ THE ABOVE CERTIFICATION AND UNDERSTAND AND AGREE TO ITS TERMS.