LULL FARM LLC
APPLICATION FOR EMPLOYMENT


PERSONAL INFORMATION
Please fill out all of the information below.

Name:  
Email Address:
Social Security Number: - - (NOT REQUIRED)
Home Phone: - -
Cell Phone: - -
Present Address:
City:
State:
Zip Code:
Are you 18 years of age or older? YES NO
Are you 16 years of age or older? YES NO
If not 16 years or older, enter age:

DESIRED EMPLOYMENT

  1. Date you wish to begin employment:      / /
  2. What is your pay expectation? $ /hour
  3. How long would you like to work at Lull? Please specify the time period you are looking for employment:

  4. How many hours would you like to work each week? hours/week
  5. List the days and times in which you are consistently UNAVAILABLE to work:

  6. What planned vacations or extended time off do you need in the next 3-6 months?

  7. Are you currently employed? YES NO
  8. Have you applied for a position with Lull Farm before? YES NO
  9. Do you have any friends or family that work at Lull Farm? YES NO

    If yes, please list their names:

  10. Have you ever been dismissed or forced to resign from employment? YES NO

    If yes, please explain:


EDUCATION

HIGH SCHOOL
  1. What is the name of the high school that you attend, or attended in the past?:     
  2. What year did you graduate high school?     
    If you have not yet graduated from high school, what is your current class standing?     
    What is your intended year of graduation?     
  3. Are you involved in any after school activities or sports?     YES NO
    If YES, what activities during each season and what is the schedule:
    Fall: Days & Time:
    Winter: Days & Time:
    Spring: Days & Time:
    Summer: Days & Time:
COLLEGE/UNIVERSITY
  1. What is the name of the college or university that you attend or attended?     
  2. What year did you graduate?     
    If you have not yet graduated, what is your current class standing?     
    What is your intended year of graduation?     
  3. What major/minor is listed on your college transcript?
    MAJOR:
    MINOR:

QUESTIONAIRE

  1. Attendance and punctuality are important factors to an employee’s success or failure with Lull Farm. How do you maintain good attendance and punctuality?

  2. What does excellent customer service mean to you?

  3. Think back through your career and life experiences. Locate a moment that was a high point, when you felt most effective and engaged. Describe how you felt, and what made the situation possible.

  4. Without being humble, describe what you value most about your self, your work, and what you would contribute to Lull Farm as an employee.

  5. Describe three concrete wishes that you have for the future of Lull Farm as a business in this community.
  6. What are three important qualities in a Lull Farm employee and WHY?

    		 WHY?
    		WHY?
    		WHY?


PREVIOUS EMPLOYMENT
List below your last three employers, beginning with the most recent.

Name of employer:
Date employed:
Job title:
Description of work:
Salary: $ /
Name of supervisor:
Phone number: - -
Employer Address:
City:
State:
Zip Code:
Reason for leaving:


Name of employer:
Date employed:
Job title:
Description of work:
Salary: $ /
Name of supervisor:
Phone number: - -
Employer Address:
City:
State:
Zip Code:
Reason for leaving:


Name of employer:
Date employed:
Job title:
Description of work:
Salary: $ /
Name of supervisor:
Phone number: - -
Employer Address:
City:
State:
Zip Code:
Reason for leaving:


PROFESSIONAL REFERENCES
Do not list any friends or relatives.

Name:
Phone number: - -
Business/Relation:
Years acquainted: years


Name:
Phone number: - -
Business/Relation:
Years acquainted: years


Name:
Phone number: - -
Business/Relation:
Years acquainted: years


Have you been convicted of a felony in the past 5 years?     YES NO
        If so, please explain:



APPLICATION SIGNATURE

“I CERTIFY THAT THE FACTS CONTAINED IN THIS APPLICATION ARE TRUE AND COMPLETE TO THE BEST OF MY KNOWLEDGE AND UNDERSTAND THAT, IF EMPLOYED, FALSIFIED STATEMENTS ON THIS APPLICATION SHALL BE GROUNDS FOR DISMISSAL.

I AUTHORIZE INVESTIGATION OF ALL STATEMENTS CONTAINED HEREIN AND THE REFERENCES AND EMPLOYERS LISTED ABOVE TO GIVE YOU ANY AND ALL INFORMATION CONCERNING MY PREVIOUS EMPLOYMENT AND ANY PERTINENT INFORMATION THEY MAY HAVE, PERSONAL OR OTHERWISE AND RELEASE THE COMPANY OF LULL FARM LLC FROM ALL LIABILITY FOR ANY DAMAGE THAT MAY RESULT FROM UTILIZATION OF SUCH INFORMATION.

I ALSO UNDERSTAND AND AGREE THAT NO REPRESENTATIVE OF THE COMPANY HAS ANY AUTHORITY TO ENTER INTO ANY AGREEMENT FOR EMPLOYMENT FOR ANY SPECIFIED PERIOD OF TIME, OR TO MAKE ANY AGREEMENT CONTRARY TO THE FOREGOING, UNLESS IT IS IN WRITING AND SIGNED BY AN AUTHORIZED COMPANY REPRESENTATIVE.”
Name:
Date: / /
Last 4 digits of SS#:

Thank You!

 

 

 

 

 

Copyright © 2010 Lull Farm LLC