Employment Application | Atkins Farms

Personal Information

First Name *

Last Name *

Street Address *

City *

State *

Zip Code *

Email Address *

Home Phone *0 / 10

Cell Phone *0 / 10

Full Time or Part Time?

Full TimePart Time

Hours Available

If you are a student, please indicate your hours available when school is in session.

New employees are required to be available at least 1 weekend day regularly, some evenings and holidays.

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

Type of Work Desired

Experience in relation to work desired/special skills & qualifications:

Do you have transportation?

Date available to start

Salary expected

Are you a U.S. Citizen?

How did you hear about the position?

Education

High School

Date Completed

College

Date Completed

Work Experience

Last Employer

Address

Phone

Supervisor

Work Performed

Start Date

End Date

Reason for leaving

Prior Employer

Address

Phone

Supervisor

Work Performed

Start Date

End Date

Reason for leaving

Prior Employer

Address

Phone

Supervisor

Work Performed

Start Date

End Date

Reason for leaving

Personal References

Name

Occupation

Address

Phone

Name

Occupation

Address

Phone

Emergency Information

Name

Relationship

Address

Home Phone

Work Phone

It is required by law that anyone under the age of 18 must have a work permit.

Do you require a work permit? Check yes if you are under 18.

YesNo

check if under 14

Do Not Contact

We may contact the employers listed on this application unless you indicate those you do not want us to contact. Do Not Contact:

Employer Name(s)

Reason

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