Careers

Can you perform the above functions? *

If you answered No, please list the reasons for any limitations you have relative to performing the above functions.

Signature *

Today's Date: *

Application for Employment

Position/Type of Work You Desire (If applying for a position as a driver, please also fill out the Experience and Qualifications—Drivers portion at the bottom):

Last Name / First Name / Middle Initial *

Mailing Address (Include Street/Box/Route, City, State, Zip Code): *

Home Phone Number:

Are you legally eligible to work in the United States? *

Have you been employed by Agri Drain Corp. previously? *

If you answered Yes, please give the dates.

How were you referred to Agri Drain Corp.?

Are you applying for:

Full-Time
Part-Time
Summer Employment

Amount of notice required before starting work:

List days available for work:

List hours available for work:

If necessary, are you available for overtime work?

Are you 18 years of age or older? *

(Federal and state laws on hazardous occupations may require you to be over 18 years old.)

If No, date of birth:

Do you have a driver's license? *

Do you have a chauffeur's license? *

Have you ever been convicted for anything other than a minor traffic violation?

If Yes, please explain:

(This information will not automatically disqualify you for employment, but may be considered in relation to the position for which you are applying.)

This company is an equal employment opportunity employer. We will not tolerate discrimination
because of race, color, religion, sex, age, physical impairment, or national origin.

All qualified applicants are welcome to submit applications for employment.

Education

High School

Name/Location of School:

Course of Study:

Number of Years Completed:

Did you graduate?

Type of Degree or Diploma:

Business/Trade/Technical

Name/Location of School:

Course of Study:

Number of Years Completed:

Did you graduate?

Type of Degree or Diploma:

College

Name/Location of School:

Course of Study:

Number of Years Completed:

Did you graduate?

Type of Degree or Diploma:

Graduate School

Name/Location of School:

Course of Study:

Number of Years Completed:

Did you graduate?

Type of Degree or Diploma:

Do you have training and/or experience in operating equipment such as table saws, routers, welders, drill presses, forklifts, band saws, iron shears, press brake, milling machines, or in machining, industrial painting, fabrication, or assembling (mechanical, electrical, hydraulic)?

If yes, please give dates and details of training and/or experience:

Other specialized skills, licenses, or training (computer skills, workshops, seminars, short courses, etc.)? Please give dates and details:

Employment

(Please give accurate, complete information regarding your previous employment and military
experience. Most recent experience should be listed first. Please explain any gaps in time.)

Company Name:

Telephone Number (include area code):

Complete Address:

Dates of Employment (From: Mo/Yr; To: Mo/Yr):

Name of Supervisor:

Final Wage ($/hour or $/month):

Job Title/Describe Job Duties and Equipment Used:

Reason for Leaving:

May we contact this employer?

Company Name:

Telephone Number (include area code):

Complete Address:

Dates of Employment (From: Mo/Yr; To: Mo/Yr):

Name of Supervisor:

Final Wage ($/hour or $/month):

Job Title/Describe Job Duties and Equipment Used:

Reason for Leaving:

May we contact this employer?

Company Name:

Telephone Number (include area code):

Complete Address:

Dates of Employment (From: Mo/Yr; To: Mo/Yr):

Name of Supervisor:

Final Wage ($/hour or $/month):

Job Title/Describe Job Duties and Equipment Used:

Reason for Leaving:

May we contact this employer?

Other Information

Please list Agri Drain employees you know:

Please list any additional information about you and/or your past work, training, or personal experiences that you would like us to consider:

References

Please name three work related, school, or personal references who are not previous supervisors.

Name:

Telephone Number(s) (include area code):

How Known By You:

Number of Years Known:

Name:

Telephone Number(s) (include area code):

How Known By You:

Number of Years Known:

Name:

Telephone Number(s) (include area code):

How Known By You:

Number of Years Known:

Signature

I attest that the above information is true, correct, and complete. If I am employed, I understand that any falsified statements or omissions of fact on this application shall be sufficient cause for dismissal.

I hereby authorize my former employers, educational institutions, and references to furnish or verify any information concerning my application for employment. I further authorize Agri Drain Corp. to contact my former employers, educational institutions, and references for the purpose of obtaining such information (unless previously stated in writing to the contrary).

I understand that my employment can be terminated at any time and for any reason by me or Agri Drain Corp., oral representations to the contrary notwithstanding. This application does not constitute an agreement or contract, or employment for any specified period or duration of time.

If I am employed, I further understand that I am required to abide by all rules and regulations as set forth by Agri Drain Corp.

I agree, as a condition of employment, to provide documents establishing proof of identify and employment eligibility in compliance with the Immigration Reform and Control Act of 1986.

I understand the information in this application may be shared with Schafer Partnership. All statements in this document referring to Agri Drain Corp. are applicable to Schafer Partnership.

I have read and fully understand the foregoing and seek employment under these conditions.

Date: *

Signature: *

Experience and Qualifications―Drivers

(Only fill out this portion if applying for a position as a driver.)

Driver's Licenses

State:

License #:

Type:

Expiration Date:

State:

License #:

Type:

Expiration Date:

State:

License #:

Type:

Expiration Date:

State:

License #:

Type:

Expiration Date:

Driving Experience

Class of Equipment:

Type of Equipment (Van, Tank, Flat, Etc.):

Dates (From: Mo/Yr; To: Mo/Yr):

Approx. # of Miles (Total):

Class of Equipment:

Type of Equipment (Van, Tank, Flat, Etc.):

Dates (From: Mo/Yr; To: Mo/Yr):

Approx. # of Miles (Total):

Class of Equipment:

Type of Equipment (Van, Tank, Flat, Etc.):

Dates (From: Mo/Yr; To: Mo/Yr):

Approx. # of Miles (Total):

Accident Record for Past 3 Years or More

Date of Last Accident:

Nature of Accident (Head-On, Rear-End, Upset, etc.)

Fatalities:

Injuries:

Next Previous Accident:

Nature of Accident (Head-On, Rear-End, Upset, etc.)

Fatalities:

Injuries:

Next Previous Accident:

Nature of Accident (Head-On, Rear-End, Upset, etc.)

Fatalities:

Injuries:

Traffic Convictions and Forfeitures for the Past 3 Years

(Other than parking violations)

Location:

Date:

Charge:

Penalty:

Location:

Date:

Charge:

Penalty:

Location:

Date:

Charge:

Penalty:

A. Have you ever been denied a license, permit, or privilege to operate a motor vehicle?

B. Has any license, permit, or privilege ever been suspended or revoked?

If the answer to either A or B is yes, please give details.

We are always accepting applications. If you would like to join our team, please fill out the application on this page and hit Submit, or print off, fill out, and submit your application today!

Agri Drain is currently hiring for the following positions:

Job Description / Requirements Overview for Plant Employees

Application for Employment

This company is an equal employment opportunity employer. We will not tolerate discrimination
because of race, color, religion, sex, age, physical impairment, or national origin.

All qualified applicants are welcome to submit applications for employment.

Education

High School

Business/Trade/Technical

College

Graduate School

Employment

Other Information

References

Signature

Experience and Qualifications―Drivers

Driver's Licenses

Driving Experience

Accident Record for Past 3 Years or More

Traffic Convictions and Forfeitures for the Past 3 Years

Careers

We are always accepting applications. If you would like to join our team, please fill out the application on this page and hit Submit, or print off, fill out, and submit your application today!

Agri Drain is currently hiring for the following positions:

Job Description / Requirements Overview for Plant Employees

Application for Employment

This company is an equal employment opportunity employer. We will not tolerate discrimination because of race, color, religion, sex, age, physical impairment, or national origin.

All qualified applicants are welcome to submit applications for employment.

Education

High School

Business/Trade/Technical

College

Graduate School

Employment

Other Information

References

Signature

Experience and Qualifications―Drivers

Driver's Licenses

Driving Experience

Accident Record for Past 3 Years or More

Traffic Convictions and Forfeitures for the Past 3 Years

This company is an equal employment opportunity employer. We will not tolerate discrimination
because of race, color, religion, sex, age, physical impairment, or national origin.