Please fill out this application completely and to the best of your ability. The information that you provide will be kept strictly confidential. Thank you for your interest in Kaup Seed & Fertilizer and Kaup Forage & Turf. Contact InformationName* First Last Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Phone*Email* Personal InformationAre you legally eligible to be employed in the United States? (proof will be required)*YesNoAre you at least 18 years or older? (If no, you may be required to provide authorization to work.)*YesNoHave you ever been convicted, pled guilty or no contest, or forfeited bond or bail for any crime other than traffic violations?*YesNoIf 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?:*YesNoIf Yes, please provide details (Where/When/Job Title):*Are you able to perform the essential functions of the job for which you are applying?*YesNoIf no, please explain:*Employment DesiredLocation Desired*West PointNorfolkPosition Applied For*When would you be available to begin work?:* Date Format: MM slash DD slash YYYY Type of employment desired:*Full-TimePart-TimeSeasonalHourly rate/salary desired*Are you currently employed?*YesNoIf so may we inquire of your present employer?:*YesNoIf presently employed, why are you considering leaving?:*EducationSchool & LocationDid you graduate?YesNoDegree Received*Subjects Studied/Major*School & LocationDid you graduate?YesNoDegree Received*Subjects Studied/Major*Employment HistoryEmployer 1Employed From Date Format: MM slash DD slash YYYY Employed To Date Format: MM slash DD slash YYYY Job TitleEmployer NameEmployer AddressEmployer PhoneEmployer Email Supervisor Name & TitleMay we contact?YesNoResponsibilitiesReason for LeavingStarting SalaryEnding SalaryEmployer 2Employed From Date Format: MM slash DD slash YYYY Employed To Date Format: MM slash DD slash YYYY Job TitleEmployer NameEmployer AddressEmployer PhoneEmployer Email Supervisor Name & TitleMay we contact?YesNoResponsibilitiesReason for LeavingStarting SalaryEnding SalaryEmployer 3Employed From Date Format: MM slash DD slash YYYY Employed To Date Format: MM slash DD slash YYYY Job TitleEmployer NameEmployer AddressEmployer PhoneEmployer Email Supervisor Name & TitleMay we contact?YesNoResponsibilitiesReason for LeavingStarting SalaryEnding SalaryReferencesReference 1RelationshipPhone NumberReference 2RelationshipPhone NumberReference 3RelationshipPhone NumberCover Letter and ResumeUpload Cover Letter and ResumeAuthorizationThe 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* Date Format: MM slash DD slash YYYY CAPTCHA