Personal Information

Please answer the following questions.

1. Are you legally eligible for employment in the U.S.A?
   : Yes     : No
   
   
2. IF you are UNDER 18 or OVER 70 years of age, please type your age in the box below:
   : If under 18 or over 70, type age.
   
   
3. What method of transportation will you use to get to work?
   : Transportation Method
   
   
4. For what position(s) are you applying?
   : Position(s)
   
   
5. What rate of pay do you expect?
   $ per week : Expected Pay Rate
   
   
6. Are you interested in Full Time or Part Time employment?
   : Full Time     : Part Time     : Either
   
   
   If you selected Part Time, please indicate the days and hours you are available...
   : When are you Available?
   
   
7. Have you been previously employed by Stock Seed Farms?
   : Yes     : No
   
   If Yes, when? -->
   
   
8. If your application is considered favorably, on what date will you be available for work?
   : Possible Start Date
   
   
9. Are there any other experiences, skills, or qualifications which you feel would especially fit you for work with our organization?
   : Other Qualifications
   
   
10. Record of Education
    Please provide the name and address, course of study, last year completed, diplomas or degrees, and indicate whether or not you graduated for each of the following: 1) Elementary/Middle School, 2) High School, 3) College and 4) any other educational facilities.
    
    
    
11. Employment
    Please provide the name and address, type of business, start and end date, telephone number, starting and ending salary, reason for leaving, and name of supervisor for up to your last four employers. Also briefly describe the work performed for each of these employers.
    
    
    
12. References
    Please list four personal references, including address and phone nubmer, who are not former employers or relatives below: