Summer Staff

Full Name*

First Middle Last

Address*

Street Address Address Line 2 City State ZIP Code

Phone*

Email*

Date Available*

Position Applied for*

Are you a citizen of the United States?*

If no, are you authorized to work in the U.S.?

Have you ever worked for Farmers Union?*

If so, when?

Have you ever been convicted of a felony?*

If yes, explain:

Education

High School (Name & Address)*

Years Attended*

Did you graduate?*

College or University (Name & Address)*

Years Attended*

Did you graduate?*

If you graduated, what is your degree in?*

Other Education (Name & Address)*

Years Attended*

Did you graduate?*

If you graduated, what is your degree in?*

References

Reference #1 (Name, company, address, phone, relationship)

Reference #2 (Name, company, address, phone, relationship)

Reference #3 (Name, company, address, phone, relationship)

Previous Employment

Employer #1*

Company Address Phone Supervisor Your Job Title

Responsibilites

Dates of Employment Reason for Leaving Beginning Salary Ending Salary

May we contact your previous supervisor for a reference?

Employer #2*

Company Address Phone Supervisor Your Job Title

Responsibilites

Dates of Employment Reason for Leaving Beginning Salary Ending Salary

May we contact your previous supervisor for a reference?

Employer #3*

Company Address Phone Supervisor Your Job Title

Responsibilites

Dates of Employment Reason for Leaving Beginning Salary Ending Salary

May we contact your previous supervisor for a reference?

Disclaimer*

By checking this box, I certify that my answers are true and complete to the best of my knowledge. If this application leads to employment, I understand that false or misleading information in my application or interview may result in my release.

Date*

APPLY NOW TO BE PART OF THE 2022 STAFF!

Summer Staff Application

Education

References

Previous Employment