Employment Application Step 1 of 5 20% Career Opportunities farmbank provides opportunities for career growth by investing in the ongoing coaching and education of our team. We are always looking for dedicated employees to join our team. Put your interests and talents to good use and discover your new career at farmbank! farmbank is an Equal Opportunity Employer At farmbank we pledge to not discriminate against employees based on race, color, national origin, sex, age, marital status, height, weight, disability or other protected characteristic. Equal access to programs, services and employment is available to all persons. Those applicants requiring a reasonable accommodation to the application and/or interview process should notify a representative of the Human Resources Department. We are an equal opportunity employer. Apply Today When applying, please remember to have your resume ready. You must complete the entire application to be considered for employment. Before submitting your application, please be sure to ask us any questions you may have.Position Applied For* Application Date* MM slash DD slash YYYY Name* First Middle Last Address* Street Address City State / Province / Region ZIP / Postal Code Home Phone*Cellular/OtherEmail* Enter Email Confirm Email Expected Pay* Would you accept full-time work?* Yes No Would you accept part-time work?* Yes No On what date would you be available for work?* MM slash DD slash YYYY If necessary, best time to call you is:* : Hours Minutes AM PM AM/PM Contact Method* Home Cellular/Other How were you referred to our Company?* Have you submitted an application here before?* Yes No If yes, please give date(s) and position(s) Have you ever been employed here?* Yes No If yes, please give dates Is this application a request for reemployment following an extended military leave of absence from our Company? If yes, additional information may be requested.* Yes No If you are under 18 years old, can you provide a work permit if required? Yes No Are you legally eligible for employment in the United States? (If yes, proof is required if hired.)* Yes No Are you able to perform the “essential functions” of the job for which you are applying (with or without reasonable accommodation)? NOTE: This question is not designed to elicit information about an applicant’s disability. Please do not provide information about the existence of a disability, particular accommodation, or whether accommodation is necessary. These issues may be addressed at a later stage, to the extent permitted by law.* Yes No Need more information about the job’s “essential functions” to respond Will you travel if required?* Yes No Will you work overtime if required?* Yes No If they have been explained to you, are you able to meet the attendance requirements of the position?* Yes No N/A Have you ever been bonded?* Yes No Please provide your driver’s license number, if driving is required for this job. State Have you entered into an agreement with any former employer or other party (such as a noncompetition agreement) that might, in any way, restrict your ability to work for our Company?* Yes No If yes, please explainNOTE: Answering “yes” to the following question does not constitute an automatic bar to employment. Factors such as date of the offense, seriousness and nature of the violation, rehabilitation and position applied for will be taken into account.Have you ever pleaded “guilty” or “no contest” to, or been convicted of, a crime?* Yes No If yes, please provide date(s) and details: Employment ExperiencePlace a checkmark by the employer(s) you DO NOT want us to contact. List your most recent employer first. Employment Experience Employer Contact Name Email Phone Address Job Title Supervisor Dates Employed - From: Dates Employed - To: Hourly rate/salary: starting Final: Work Performed Reason for leaving What did you like most about your position? What were the things you liked least about the position? Actions Edit Delete There are no Entries. Add Entry Maximum number of entries reached. Explain any gaps in your employment, other than those due to personal illness, injury or disability.Have you ever been fired or asked to resign from a job?* Yes No If yes, please explain Education BackgroundUntitled Type of Education School Name Location Course of Study Degree or Diploma Did you graduate? Actions Edit Delete There are no Entries. Add Entry Maximum number of entries reached. Continuing EducationSpecial Training or SkillsLanguages, machine operation, etc., that would be of benefit in the job for which you are applying. ReferencesList names and telephone numbers of three business/work references who are not related to you and are not previous supervisors. If not applicable, list three school or personal references who are not related to you.Name Title Relationship to You PhoneEmail Years Known Name Title Relationship to You PhoneEmail Years Known Name Title Relationship to You PhoneEmail Years Known I certify that all the information submitted by me on this application is true and complete, and I understand that if any false or misleading information, omissions or misrepresentations are discovered, my application may be rejected, and if I am employed, my employment may be terminated at any time. If hired, I agree to conform to the Company’s rules and regulations, and I understand that these rules and/or the employee handbook do not form a contract of employment either express or implied, and I agree that my employment and compensation can be terminated, with or without cause and with or without notice, at any time, at either my or the Company’s option. I also understand and agree that the terms and conditions of my employment may be changed, with or without cause and with or without notice, at any time by the Company. I understand that no Company representative, other than its president, and then only when in writing and signed by the president, has any authority to enter into any agreement for employment for any specific period of time, or to make any agreement contrary to the forgoing. I expressly authorize, without reservation, the employer, its representatives, employees or agents to contact and obtain information from all references (personal and professional), employers, public agencies, licensing authorities and educational institutions and to otherwise verify the accuracy of all information provided by me in this application, résumé or job interview. I hereby waive any and all rights and claims I may have regarding the employer, its agents, employees or representatives for seeking, gathering and using truthful and nondefamatory information, in a lawful manner, in the employment process and all other persons, corporations or organizations for furnishing such information about me. I understand that this application remains current for only 30 days. At the conclusion of that time, if I have not heard from the employer and still wish to be considered for employment, it will be necessary for me to reapply and fill out a new application. I also understand that, if I am hired, I will be required to provide proof of identity and legal authorization to work in the United States as required by federal immigration laws. This Company does not tolerate unlawful discrimination or harassment based on sex, race, color, religion, national origin, citizenship, age, disability, or any other protected status under applicable federal, state or local law. No question on this application is used to limit or exclude an applicant from employment consideration on any basis prohibited by applicable federal, state or local law. Applicant's Signature* Date* MM slash DD slash YYYY
