Job Application

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Title: AGRICULTURAL SERVICE TECHNICIAN

Fields marked with an asterisk (*) must be filled out before submitting.

Personal Details

First Name *
Middle Name
Last Name *

Contact Details

Phone *
Email Address *
Address *
City *
State *
Zip *

Education

What is the highest level of education you have completed? *
If college, what is your degree? *
List any specialized training, skills, or abilities not covered by your employment history that would be helpful if you are employed by Legacy Farm & Lawn
List any languages other than English that you can speak, read, and/or write

Employment History

Are you currently employed? *

Current (or most recent) Employer

Employer Name
Type of Business
Phone
Address
City
State
Zip
Title of Your Position
Start Date
End Date
Name and Title of Immediate Supervisor
Final Pay
Payment Frequency
Description of duties, responsibilities, and equipment operated
What did you like most about this job?
What did you like least about this job?
Reason for Leaving
May we contact this employer?

Previous Employer 1

Employer Name
Type of Business
Phone
Address
City
State
Zip
Title of Your Position
Start Date
End Date
Name and Title of Immediate Supervisor
Final Pay
Payment Frequency
Description of duties, responsibilities, and equipment operated
What did you like most about this job?
What did you like least about this job?
Reason for leaving
May we contact this employer?

Previous Employer 2

Employer Name
Type of Business
Phone
Address
City
State
Zip
Title of Your Position
Start Date
End Date
Name and Title of Immediate Supervisor
Final Pay
Payment Frequency
Description of duties, responsibilities, and equipment operated
What did you like most about this job?
What did you like least about this job?
Reason for Leaving
May we contact this employer?

Previous Employer 3

Employer Name
Type of Business
Phone
Address
City
State
Zip
title of your Position
Start Date
End Date
Name and Title of Immediate Supervisor
Final Pay
Payment Frequency
Description of duties, responsibilities, and equipment operated
What did you like most about this job?
What did you like least about this job?
Reason for Leaving
May we contact this employer?

Check All That Apply

Are you legally eligible to work in the United States? Yes
No
On what date would you be available to start working?
Are you available to work… Full-time
Weekends
3rd Shift
1st Shift
What days are you available to work? Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Do you know anyone who is currently employed with Legacy farm & Lawn? Yes
No
If yes, who are they and what is your relationship with them?
Have you previously worked for Legacy Farm & Lawn Yes
No
Have you been convicted of a felony within the last 7 years? (A conviction will not necessarily disqualify an applicant from employment) Yes
No
If yes, please explain when, where, and disposition of the case
Have you served in a branch of the U.S. Armed Forces or National Guard? Yes
No
If yes, describe your experience
Do you currently have a valid drivers license? Yes
No
State of License
License Number
Please list dates of any drivers license suspensions (if any)
Do you currently have a reliable source of transportation? Yes
No

Professional References

Reference One Name
Title
Phone Number
Relationship to this reference
Reference Two Name
Title
Phone Number
Relationship to this reference
Reference Three Name
Title
Phone Number
Relationship to this reference

Optional Resume Upload

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How did you learn of this job opening?