Employment Application – Kaup Seed & Fertilizer Inc.

Contact Information

Name*

First Last

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone*

Email*

Personal Information

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

Yes
No

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

Yes
No

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

Yes
No

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
No

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
No

If no, please explain:*

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
No

If so may we inquire of your present employer?:*

Yes
No

If presently employed, why are you considering leaving?:*

Education

School & Location

Did you graduate?

Yes
No

Degree Received*

Subjects Studied/Major*

School & Location

Did you graduate?

Yes
No

Degree Received*

Subjects Studied/Major*

Employment History

Employer 1

Employed From

Employed To

Job Title

Employer Name

Employer Address

Employer Phone

Employer Email

Supervisor Name & Title

May we contact?

Yes
No

Responsibilities

Reason for Leaving

Starting Salary

Ending Salary

Employer 2

Employed From

Employed To

Job Title

Employer Name

Employer Address

Employer Phone

Employer Email

Supervisor Name & Title

May we contact?

Yes
No

Responsibilities

Reason for Leaving

Starting Salary

Ending Salary

Employer 3

Employed From

Employed To

Job Title

Employer Name

Employer Address

Employer Phone

Employer Email

Supervisor Name & Title

May we contact?

Yes
No

Responsibilities

Reason for Leaving

Starting Salary

Ending Salary

References

Reference 1

Relationship

Phone Number

Reference 2

Relationship

Phone Number

Reference 3

Relationship

Phone Number

Cover Letter and Resume

Upload Cover Letter and Resume

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*

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