Applicant Information Name * First Name Last Name Phone Number Address Address 1 Address 2 City State/Province Zip/Postal Code Country Email * Are you 18 years of age or older? * Yes No Are you legally authorized to work in the United States? * Yes No Do you or anyone in your household currently have contact with swine that would create a biosecurity concern? * Yes No Today's Date MM DD YYYY Desired Salary * Are you willing to relocate? * Yes No Have you previously been employed by us? * Yes No What kind of employment are you looking for? Select all that apply. * Full-time Part-time Temporary Are you willing to work weekends? * Yes No Position(s) apply for - Select all that apply: Swine Technician Sow Farm Wean to finish Office/Clerical Feed Mill Driver Other If applying for "Other", please fill-in the blank: How did you hear about us? Newspaper Walk-in Radio School Other If you were referred, who were you referred by? Education History High school name and location College/technical college name and location Please list your degrees Employment History 1. Employer Job Title Contact Phone (###) ### #### Reason for leaving Date Started MM DD YYYY Date Left MM DD YYYY May We Contact Them? Yes No Describe Job Duties 2. Employer Job Title Contact Phone (###) ### #### Reason for leaving Date Started MM DD YYYY Date Left MM DD YYYY May We Contact Them? Yes No Describe Job Duties Experience/Knowledge Pig Skills - Select all that apply: Select All Loading, unloading and moving Artificial insemination Farrowing Treating pigs and vaccination Other Livestock - Select all that apply: Select All Cattle Sheep Poultry Horses General Equipment - Select all that apply: Curtain management Feed systems Cooling systems Gas heaters Boilers Pressure washers Feeders and augers Manure management systems Transportation - Select all that apply: Select All CDL Semi trailer certified Air break certified Experienced driving a pickup with stock trailer Experienced in hauling livestock Experienced in hauling grain Computer Skills - Select all that apply: Select All Microsoft Products Internet Explorer MAS 90 Other software Feed Mill - Select all that apply: Select All Mixing feed Pelleting Loading trucks Other Experience - Select all that apply: Select All Sales Administrative assistance Customer Service Accounting Current Certification - Select all that apply: Select All PQA+ Certification TQA Certification Other Skills Not Listed References 1. Name First Name Last Name Relationship Phone Number 2. Name First Name Last Name Relationship Phone Number Certification and Acknowledgement * I certify the information contained in this application is accurate, true and completed to the best of my knowledge and understand, if hired, falsified statements on the application shall be grounds for dismissal. I authorize investigation of all statements contained herein and all information concerning my previous employment and any pertinent information they may have and release all parties from all liability for any damage that may result from furnishing same to you. I understand, if hired, my employment is for no definite period and may, regardless of the date of payment of my wages and salary, be terminated at any time without prior notice. I authorize and agree to submit to any pre-employment drug screen, if I should be offered a position. I agree. Thank you for your application!
