Job Application – Riddle Plant Farm

Name*

First

Last

Middle

Phone*

Alternate Phone

Today's Date*

Email*

Address*

Street Address Street Address Line 2 City State / Province / Region Postal / Zip Code

1. Are you employed at the current time?*

2. If hired, can you show proof of your legal right to work in the U.S.?*

3. If offered a position, when can you report for work?*

4. Can you provide a valid Oklahoma State ID? *

5. Are you at least 18 years old?*

6. Have you ever been dismissed or asked to resign from any position?*

7. Have you ever been convicted of a felony or misdemeanor which resulted in imprisonment? (A yes answer to this question does not necessarily disqualify any applicant from employment)*

If you answered yes to questions 6 or 7, please explain here

Position for which you are applying:*

Location for which you are applying:*

Sand Springs

Broken Arrow

Sand Springs and/or Broken Arrow

Please list current days available: (Both Saturday and Sunday are required days; we are not currently interviewing applicants unavailable on Saturday or Sunday)

Generally our shifts are 8:45-6 Mon-Sat & 11-5 Sunday. On the days you are available, do you have any scheduling conflicts with these times?

Please list all schools attended: High School

Subjects studied or degrees obtained: High School

Did you graduate? (High School)

Yes

No

GED

Please list all schools attended: College

Subjects studied or degrees obtained: College

Did you graduate? (College)

Yes

No

Some Completed

Still Enrolled

Please list all schools attended: Other

Subjects studied or degrees obtained: Other

Did you graduate? (Other)

Yes

No

Some Completed

Still Enrolled

1) Most Recent Employer Name & Address

1) Supervisor Name & Phone Number

1) Date Range of Employment

1) Position & Responsibilities

1) End Salary

1) Reason for Leaving

2) Second Most Recent Employer Name & Address

2) Supervisor Name & Phone Number

2) Date Range of Employment

2) Position & Responsibilities

2) End Salary

2) Reason for Leaving

3) Third Most Recent Employer Name & Address

3) Supervisor Name & Phone Number

3) Date Range of Employment

3) Position & Responsibilities

3) End Salary

3) Reason for Leaving

Please use the space below to list any other education or experience you have that could pertain to the position for which you are applying :

Why do you want to work here?*

Please list THREE personal references who are not relatives or former supervisors. Must include: 1) Name 2) Telephone 3) Occupation 4) Years Known*

In case of emergency, accident or illness, please list contact: 1) Name 2) Phone Number 3) Alternate Phone Number 4) Relationship to Applicant*

As a part of our procedure for processing your employment application, your personal and employment references may be checked. If you have misrepresented or omitted any facts on this application and are subsequently hired, you may be discharged from your job. You may make a written request for information derived from the checking of your references. If necessary for employment, you may be required to: supply your birth certificate or other proof of authorization to work in the United States, have a physical examination and/or drug test, or to sign a conflict of interest agreement and abide by its terms. Do you understand and agree to the information provided above? *

Yes

No

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