Employment Application

Name*

First and last name

Phone

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

If under 18, please list age

E-Mail*

Position applying for*

Select All
Server / Bar
Kitchen
Fall (admissions, pumpkin patch, corn maze)
Outside - mowing etc.
Cashier/deli/miscellaneous

Days & Hours available to work*

Highest school grade completed. If a student, please list school attending.*

Work Experience*

Please list any and all work experience for the last five years. Include job title, dates of employment, duties performed, starting & ending pay rate.

References*

Please provide 3 references with phone numbers who are NOT related to you. Could be co-workers, past employers, teachers, clergy etc.

Last Supervisor

Please enter name & phone #of your last supervisor

May we contact your former supervisor

Yes
No

Have you ever been convicted of a felony

Yes
No

If you have any friends or relatives employed at Maize Valley please list here.

Did you complete this application yourself?*

Yes
No

Other Comments

Please use this space for any other comments or experiences you wish to add.

Do you agree that everything contained in this application is true?*

Yes
No

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Employment Application

Job Application

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