Employment Form

JUDD RANCH, INC

Application for Employment

PRE-EMPLOYMENT APPLICATION – AN EQUAL OPPORTUNITY EMPLOYER

First Name

Last Name

Middle

Address

Phone Number

Are you 18 years or older

Yes

Date you can start

Salary desired

Are you employed now?

Yes

May we inquire of your present employer?

Yes

Present Employer and Contact

Education

Did you graduate from high school?

Yes

If you answered yes, please provide the high school name and location

Did you graduate from college?

Yes

If you answered yes, please provide the college name and location

If you answered yes, what degree did you earn?

Did you attend trade school or other education?

Which of these jobs did you like best?

What did you like most about this job?

References

List 3 references who are NOT related to you

Reference

Contact Name / Address / Phone

Business

Years Acquainted

Reference

Contact Name / Address / Phone

Business

Years Acquainted

Reference

Contact Name / Address / Phone

Business

Years Acquainted

Other Information

Have you ever been convicted of a crime? (besides a traffic violation)

Yes

If yes, explain

Are you a veteran?

In case of emergency, notify (include name, address, and phone)

I CERTIFY THAT THE FACTS CONTAINED IN THIS APPLICATION ARE TRUE AND COMPLETE AND UNDERSTAND THAT FALSIFIED STATEMENTS ON THIS APPLICATION SHALL BE GROUNDS FOR DISMISSAL.

I AUTHORIZE INVESTIGATION OF ALL STATEMENTS CONTAINED HEREIN AND THE REFERENCES LISTED ABOVE TO GIVE YOU ANY AND ALL INFORMATION CONCERNING MY PREVIOUS EMPLOYMENT AND ANY PERTINENT INFORMATION THEY MAY HAVE, AND RELEASE ALL PARTIES FROM ALL LIABILITY AND ANY DAMAGE THAT MAY RESULT FROM FURNISHING INFORMATION TO YOU.

I UNDERSTAND AND AGREE THAT, IF HIRED, MY EMPLOYMENT IS FOR NO DEFINITE PERIOD AND MAY BE TERMINATED AT ANY TIME WITHOUT PRIOR NOTICE AND WITHOUT CAUSE.

Date Signed

Print Full Name as Signature By entering your full name here, you are legally signing this employment application.