Frenchman Valley Coop - Employment Application

First Name

Last Name

Phone Number

Current Address

City

State

Zip Code

Former Address

City

State

Zip Code

Are you 18 years of age or older?

Yes

Are you legally eligible to work in the United States?

Yes

Rate of Pay Expected

Position Desired

Have you worked for FVC?

Yes

How did hear about FVC?

Other

Highest Education Level

School Attendance Start Month

School Attendance Start Year

School Attendance End Month

School Attendance End Year

School Name

City, State

Degree Achieved

Employment History

Education

Company Name

Address

Telephone

Supervisor

Dates of Employment

Description of Duties

Reason for Leaving

May We Contact?

Yes

Please read below before signing:

The information I have provided in this Application for Employment is true, correct and complete. False, incomplete or misrepresented information of any kind, will be sufficient cause for my application to be rejected or, if discovered after I am employed, cause for immediate termination of my employment.

I authorize the employer to contact and obtain information about me from previous employers, educational institutions, and “references” I provided, and any other party necessary to verify the accuracy of information I disclosed in this application, a related employment resume or a personal interview. To assist in the processing of my Application, I waive all rights and claims I may otherwise have against the employer or its representatives, for seeking, and using information to evaluate my employment request and all other persons, corporations or organizations who provide information for this purpose.

This application will expire in 30 days. After that date, unless otherwise notified, I understand that my status as an applicant will end. I may re-apply for employment in the future by completing a new application. This application is not an employment agreement. If I accept an offer of employment I understand my relationship with the company is of an "at will" nature I may resign at any time, and the employer may terminate my employment at any time, with or without cause and without prior notice, unless required by law. I understand that no one, other than an executive officer of the employer, has authority to enter into any employment agreement with terms contrary to the foregoing and then only in writing signed by such officer. Pre-Employment Urinalysis Consent: I understand as a condition of employment with Frenchman Valley Coop I must submit to a controlled substance test. A urine sample will be collected and tested for controlled substances. I also understand that if I test positive for use of controlled substances, I will not be considered for employment with Frenchman Valley Coop. I fully understand and accept all terms and conditions in the above statement.

I have read and understand all information.

Yes

Signature

Date

Applicant Statement

Required field

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