Date
MM
DD
YYYY
Name
*
First Name
Last Name
Address
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Phone
(###)
###
####
Email
*
Emplyment Desired
*
Position applying for:
Personal Information
Have you ever applied to or worked for Coe Orchard Equipment, Inc. before?
If yes, when?
Do you have any friends or relatives working for Coe Orchard Equipment, Inc.?
If yes, state name (s) and relationships:
Why are you applying for work at Coe Orchard Equipment, Inc.?
*
If hired, would you have a reliable means of transportation to and from work?
*
Are you at least 18 years old (if under 18, hire is subject to verification that you are of minimum legal age)
*
If hired, can you present evidence of your U.S. citizenship or proof of your legal right to live and work in this country?
*
Education, Training, and Experience
High School Name
Address
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Number of Years Completed
Did you Graduate?
*
Degree or Diploma?
Education, Training, and Experience Cont.
College/University Name
Address
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Number of Years Completed
Did you Graduate?
Degree or Diploma?
Education, Training, and Experience Cont.
Vocational/ Business Name
Address
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Number of Years Completed
Did you Graduate?
Degree or Certification
Employment History
List below all present and past employment starting with your most recent employer (list all employers you've worked for, use attached sheets in the back if you need more room). Account for all periods of employment. You must complete this section even if attaching a resume.
Name of Employer
Phone
(###)
###
####
Type of Business
Supervisor's Name
First Name
Last Name
Address
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Dates of Employment
Start Date - End Date
Your position and duties
Reason for leaving
May we contact this employer for a reference?
Employment History (cont.)
Name of Employer
Phone
(###)
###
####
Type of Business
Supervisor's Name
First Name
Last Name
Address
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Dates of Employment
Start Date - End Date
Your position and duties
Reason for leaving
May we contact this employer for a reference?
Employment History (cont.)
Name of Employer
Phone
(###)
###
####
Type of Business
Supervisor's Name
First Name
Last Name
Address
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Dates of Employment
Start Date - End Date
Your position and duties
Reason for leaving
May we contact this employer for a reference?
Employment History (cont.)
Name of Employer
Phone
(###)
###
####
Type of Business
Supervisor's Name
First Name
Last Name
Address
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Dates of Employment
Start Date - End Date
Your position and duties
Reason for leaving
May we contact this employer for a reference?
Employment History (cont.)
Name of Employer
Phone
(###)
###
####
Type of Business
Supervisor's Name
First Name
Last Name
Address
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Dates of Employment
Start Date - End Date
Your position and duties
May we contact this employer for a reference?
Employment History (cont.)
Name of Employer
Phone
(###)
###
####
Type of Business
Supervisor's Name
First Name
Last Name
Address
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Dates of Employment
Start Date - End Date
Your position and duties
Reason for leaving
May we contact this employer for a reference?
Reference 1
List below three persons not related to you who have knowledge of your work performance within the last three years.
First Name
Last Name
Phone
(###)
###
####
Address
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Occupation
Number of years acquainted
Reference 2
First Name
Last Name
Phone
(###)
###
####
Address
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Occupation
Number of years acquainted
Reference 3
First Name
Last Name
Phone
(###)
###
####
Address
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Occupation
Number of years acquainted
Please read carefully, and check that you have acknowledged each of the paragraphs below.
I hereby certify that I have not knowingly withheld any information that might adversely affect my chances for employment and that the answers given by me are true and correct to the best of my knowledge. I further certify that I, the undersigned applicant, have personally completed this application. I understand that any omission or misstatement of material fact on this application or on any document used to secure employment shall be grounds for rejection of this application or for immediate discharge if I am employed, regardless of the time elapsed before discovery.
I hereby authorize Coe Orchard Equipment, Inc. to thoroughly investigate my references, work record, education and other matters related to my suitability for employment and, further, authorize the references I have listed to disclose to the company and all letters, reports and other information related to my work records, without giving me prior notice of such disclosure. In addition, I hereby release the Company, my former employers and all other person, corporations, partnerships, and associations from any, and all claims, demands or liabilities arising out of or in any way related to such investigation or disclosure.
I understand that nothing contained in the application or conveyed during any interview which may be granted or during my employment, if hired, is intended to create an employment contract between me and the company. In addition, I understand and agree that if I am employed, my employment is for no definite or determinable period and may be terminated at any time, with or without prior notice, at the option of either myself or the company, and that no promises or representations contrary to the foregoing or binding on the company unless made in writing and signed by me and the company’s designated representative.
