Application for Employment

Please fill out all information below and a Waukon Feed Ranch, Inc. Representative will be touch shortly.

 CLICK THE LINKS BELOW TO PRINT AND MAIL/FAX APPLICATION

English

Spanish

Personal
Full Name(First, Middle, Last) *
Current Address:(Number, Street, City, State, Zip Code) *
Date of Application *
Email *
Telephone Number *
Are you 18 or older? * Yes
No
If no, are you at least 16 years old? * Yes
No
Are you a Military Veteran? * Yes
No
If yes, dates of active duty
Have you ever been convicted of a crime? * Yes
No
Are you currently employed? * Yes
No
Can you work overtime? * Yes
No
Can you work weekends if job require it? * Yes
No
Are you capable of performing in a reasonable matter, with or without reasonable accommodations, the activities involved in the job for which you have applied? * Yes
No
Do you have reliable transportation to get to work? * Yes
No
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Job Position
Job Title *
Date you can start *
How did you learn about this opening? *
Looking for: * Full-Time
Part-Time
Seasonal
CDLS ONLY
Drivers License Number
DOB
Has any license, permit, or driving privilege ever been suspended or revoked? Yes
No
I authorize Waukon Feed Ranch to run my motor vehicle record Yes
No
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Education
High School
Name of School
Location
Completed Yes
No
Completed date
Type of Degree or Certificate
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University
Name of School
Location
Completed Yes
No
Completed Date
Type of Degree or Certificate
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Certificate
Name of School
Location
Completed Yes
No
Completed Date
Type of Degree or Certificate
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Employment Record
Former Employment: (List employers from most recent to least.)
Company Name
Job Title
Address(Number, Street, City, State, Zip)
Start Date
End Date
Salary
Reason for Leaving
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Company Name
Job Title
Address(Number, Street, City, State, Zip)
Start Date
End Date
Salary
Reason for Leaving
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Company Name
Job Title
Address(Number, Street, City, State, Zip)
Start Date
End Date
Salary
Reason for Leaving
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May we contact your former employers? Yes
No
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References
(Please do not include Family Members)
Name
Phone Number
Email
Occupation
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Name
Phone Number
Email
Occupation
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Name
Phone Number
Email
Occupation
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(NOTE: This institution does not discriminate in hiring or any other decision on the basis of race, color, sex, citizenship, national origin, ancestry, Vietnam era veteran status, or on the basis of age or physical or mental disability unrelated to ability to perform the work required. No question on this application is intended to secure information to be used for such discrimination.) I voluntarily give this institution the right to make a thorough investigation of my past employment, education, professional experience, and references, agree to cooperate in such investigation and release from all liability or responsibility all persons, companies or corporations supplying such information. I understand that my employment is at will, and that either party is free to terminate the employment relationship at any time without cause. I also understand that my employment may be terminated for any misstatement or omission of fact appearing on this application form. By signing below, I certify that the answers and information set out above are true, accurate, and correct to the best of my knowledge. I acknowledge that if any answer or information is not true, accurate, or complete, I may not be hired.
Electronic Signature *
Date *
* Required field

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