Employment Application – Attebury Grain, LLC.

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Attebury Application For Employment

Step 1 of 6

16%

APPLICANT INFORMATION
Name*
First Middle Last
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Social Security Number*
Phone*
Alternate Phone
Email*
Position Applied For*
Date Available*
Desired Salary*
Type Of Employment*
- Full Time
- Part Time
- Seasonal
- Summer
If you cannot work full time, please explain:
Are you able to perform the essential functions of the position for which you are applying with or without accommodations?*
- YES
- NO
If no, please explain. (If you have any question as to what functions are applicable to the position for which you are applying, please ask the interviewer before you answer this question.)
Are you available to work:*
- Days
- Nights
- Weekends
Days and Hours Available:
Sunday*
Monday*
Tuesday*
Wednesday
Thursday*
Friday*
Saturday*
ATTEBURY IS AN EQUAL OPPORTUNITY EMPLOYER, DEDICATED TO A POLICY OF NON-DISCRIMINATION IN EMPLOYMENT ON ANY BASIS INCLUDING RACE, AGE, GENDER, RELIGION, COLOR, CREED, ANCESTRY, SET, MARITAL STATUS, VETERANS STATUS, DISABILITY OR NATIONAL ORIGIN.

Are you currently employed?*
- YES
- NO
May we contact?*
- YES
- NO
- N/A
If currently employed, why are you considering leaving? Have you ever applied with this company?*
Do you have any relatives or friends who work for the Company?*
- YES
- NO
If yes, who and where do they work?*
How did you hear about us?*
- Walk-In
- Advertisement
- Other
Are you a citizen of the United States?*
- YES
- NO
If no, are you legally authorized to work in the U.S.? (Proof of identity and eligibility will be required upon employment)*
- YES
- NO
Have you ever been convicted of a felony which resulted in imprisonment within the last seven years?*
- YES
- NO
If yes, please explain:*
(A conviction will not automatically disqualify you for employment. Rather, such factors as age and date of conviction, seriousness and nature of the crime, and rehabilitation will be considered).
EDUCATION
High School
Location
Did you graduate and when?
College
Location
Did you graduate and when?
Graduate Level
Location
Did you graduate and when?
Trade School
Location
Did you graduate and when?
ATTEBURY IS AN EQUAL OPPORTUNITY EMPLOYER, DEDICATED TO A POLICY OF NON-DISCRIMINATION IN EMPLOYMENT ON ANY BASIS INCLUDING RACE, AGE, GENDER, RELIGION, COLOR, CREED, ANCESTRY, SET, MARITAL STATUS, VETERANS STATUS, DISABILITY OR NATIONAL ORIGIN.

Experience/Skills related to the position for which you are applying:
Skill/Attitude
Words Per Minute
Software Used
Skill/Attitude
Years Experience
Years Experience
Words Per Minute
Software Used
Skill/Attitude
Years Experience
Words Per Minute
Software Used
List training courses completed and any other training which may be helpful in considering your application.
EMPLOYMENT HISTORY
Include your last seven (7) years of employment history, including periods of unemployment, starting with the most recent and working backwards in time. Incomplete information could disqualify you from further consideration. Add a separate page if necessary.
COMPANY, PHONE, ADDRESS, SUPERVISOR, JOB TITLE, STARTING SALARY, ENDING SALARY, RESPONSIBILITIES, START DATE, END DATE, REASON FOR LEAVING.
May we contact your previous supervisor for a reference?
- YES
- NO
COMPANY, PHONE, ADDRESS, SUPERVISOR, JOB TITLE, STARTING SALARY, ENDING SALARY, RESPONSIBILITIES, START DATE, END DATE, REASON FOR LEAVING.
May we contact your previous supervisor for a reference?
- YES
- NO
COMPANY, PHONE, ADDRESS, SUPERVISOR, JOB TITLE, STARTING SALARY, ENDING SALARY, RESPONSIBILITIES, START DATE, END DATE, REASON FOR LEAVING.
May we contact your previous supervisor for a reference?
- YES
- NO
COMPANY, PHONE, ADDRESS, SUPERVISOR, JOB TITLE, STARTING SALARY, ENDING SALARY, RESPONSIBILITIES, START DATE, END DATE, REASON FOR LEAVING.
May we contact your previous supervisor for a reference?
- YES
- NO
COMPANY, PHONE, ADDRESS, SUPERVISOR, JOB TITLE, STARTING SALARY, ENDING SALARY, RESPONSIBILITIES, START DATE, END DATE, REASON FOR LEAVING.
May we contact your previous supervisor for a reference?
- YES
- NO
ATTEBURY IS AN EQUAL OPPORTUNITY EMPLOYER, DEDICATED TO A POLICY OF NON-DISCRIMINATION IN EMPLOYMENT ON ANY BASIS INCLUDING RACE, AGE, GENDER, RELIGION, COLOR, CREED, ANCESTRY, SET, MARITAL STATUS, VETERANS STATUS, DISABILITY OR NATIONAL ORIGIN.

COMPANY, PHONE, ADDRESS, SUPERVISOR, JOB TITLE, STARTING SALARY, ENDING SALARY, RESPONSIBILITIES, START DATE, END DATE, REASON FOR LEAVING.
May we contact your previous supervisor for a reference?
- YES
- NO
COMPANY, PHONE, ADDRESS, SUPERVISOR, JOB TITLE, STARTING SALARY, ENDING SALARY, RESPONSIBILITIES, START DATE, END DATE, REASON FOR LEAVING.
May we contact your previous supervisor for a reference?
- YES
- NO
Have you ever been discharged or asked to resign from a job?*
- YES
- NO
If yes, please explain:*
Do you have any special skills, experience and/or training that would enhance your ability to perform the position applied for?*
- YES
- NO
If yes, please explain:*
ATTEBURY IS AN EQUAL OPPORTUNITY EMPLOYER, DEDICATED TO A POLICY OF NON-DISCRIMINATION IN EMPLOYMENT ON ANY BASIS INCLUDING RACE, AGE, GENDER, RELIGION, COLOR, CREED, ANCESTRY, SET, MARITAL STATUS, VETERANS STATUS, DISABILITY OR NATIONAL ORIGIN.

REFERENCES
FULL NAME, RELATIONSHIP (LANGUAGE SPOKE), COMPANY, PHONE, ADDRESS, EMAIL
FULL NAME, RELATIONSHIP (LANGUAGE SPOKE), COMPANY, PHONE, ADDRESS, EMAIL
FULL NAME, RELATIONSHIP (LANGUAGE SPOKE), COMPANY, PHONE, ADDRESS, EMAIL
APPLICANT’S CERTIFICATION AND AGREEMENT
PLEASE READ VERY CAREFULLY
I hereby certify that the facts set forth in the above employment application are true and complete to the best of my knowledge and authorize Attebury Grain, LLC to verify their accuracy and to obtain reference information on my work performance. I, hereby release Attebury Grain, LLC from any/all liability of whatever kind and nature which, at any time, could result from obtaining and having an employment decision based on such information.

I understand that, if employed, falsified statements of any kind or omissions of facts called for on this application may disqualify me from further consideration for employment and shall be considered sufficient basis for dismissal if determined at a later date.

I authorize you to communicate with persons listed as references, former employers, and any others with whom you desire to check. I agree to hold such persons harmless with respect to any information they may give about me.

In consideration of my employment, if I am employed, I agree to conform to the employment policies and rules of the Company. I understand that my employment and compensation can be terminated, with or without notice, at any time, at the option of either the Company or myself. I understand that no representative of the Company, other than the Managing Director, has the authority to enter into any agreement for employment for any specified period of time, or to make any agreement contrary to the foregoing. I further understand that neither the policies, rules, regulations of employment nor anything said during the interview process shall be deemed to constitute the terms of an implied employment contract.

If employed, I agree to engage in no outside activity which would involve a material conflict of interest with, or which could reflect adversely on the Company. I understand this decision is to rest with the Company.

I understand that the Company requires the successful completion of a urinalysis for drug testing purposes and/or a blood alcohol test as a condition of employment. By submitting this Application for Employment, I hereby consent to either or both of said tests, at the Company's discretion. This application for employment is good for 30 days. Consideration for employment after 30 days requires a new application.
Signature*
Date*
Date Format: MM slash DD slash YYYY
ATTEBURY IS AN EQUAL OPPORTUNITY EMPLOYER, DEDICATED TO A POLICY OF NON-DISCRIMINATION IN EMPLOYMENT ON ANY BASIS INCLUDING RACE, AGE, GENDER, RELIGION, COLOR, CREED, ANCESTRY, SET, MARITAL STATUS, VETERANS STATUS, DISABILITY OR NATIONAL ORIGIN.

ATTEBURY IS AN EQUAL OPPORTUNITY EMPLOYER, DEDICATED TO A POLICY OF NON-DISCRIMINATION IN EMPLOYMENT ON ANY BASIS INCLUDING RACE, AGE, GENDER, RELIGION, COLOR, CREED, ANCESTRY, SET, MARITAL STATUS, VETERANS STATUS, DISABILITY OR NATIONAL ORIGIN.

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