Apply – Country Boy Farms

It is our policy to comply with all applicable state and federal laws prohibiting discrimination in employment based on race, age, color, sex, religion, national
origin, disability, or other protected classifications. Please carefully read and answer all questions. You will not be considered for employment if you fail to
completely answer all the questions on this application. You may attach a resume, but all questions must be answered.

Title

Are you at least 21 years old? MUST BE 21 TO APPLY.

First Name

Last Name

Email Address

Contact Number

Position applied for:

Date available to start:

Have you ever been convicted of a felony? (Convictions will not necessarily disqualify an applicant for employment).

Yes

If yes, please provide date, place and nature for all convictions

Desired wage:

Employment Type

Hours:

How were you referred to Country Boy Farms?

May we contact previous employers?

Yes

Are you authorized to work in the U.S. on an unrestricted basis?

Yes

Do you have a High School Diploma or GED?

Yes

Work History #1

Title

Company

Supervisor

Supervisor Number

State

Zip

Duties

Start Date

End Date

Reason for Leaving

End Salary

Work History #2

Title

Company

Supervisor

Supervisor Number

State

Zip

Duties

Start Date

End Date

Reason for Leaving

End Salary

Work History #3

Title

Company

Supervisor

Supervisor Number

State

Zip

Duties

Start Date

End Date

Reason for Leaving

End Salary

Reference #1

Reference #2

Reference #3

Address

Phone

Relationship

I certify that the facts set forth in this Application for Employment are true and complete to the best of my knowledge. I understand that if I am
employed, false statements, omissions, or misrepresentations may result in my dismissal. I authorize Country Boy Farms to make an
investigation of any of the facts set forth in this application and release Country Boy Farms from any liability. Country Boy Farms may contact
any listed references on this application.
I acknowledge and understand that Country Boy Farms is an “At Will” employer. Therefore, any employee (regular, temporary, or other type of
category employee) may resign at any time, just as Country Boy Farms may terminate the employment relationship with any employee at any
time, with or without cause, with or without notice to the other party.

Applicant Signature

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