Online Application

    Your Employment is subject to verification that you meet minimum legal age requirements and
    that you are legally qualified to work in the United States of America.

    Date

    Position Applied For

    Name*

    Email*

    Address (PO Box, Street, City, State, Zip)

    Phone

    Select Last Primary Grade Completed
    123456789101112

    Education

    High School (School Name, Location, Years Completed, Type of Degree)

    College/Vocational (School Name, Location, Years Completed, Type of Degree)

    College/Vocational (School Name, Location, Years Completed, Type of Degree)

    List job skills acquired / seminars attended / on the job training received / machines that you
    can operate, etc. and level of proficiency.

    Honors received/professional memberships/offices held:
    (If you wish, you may exclude those, which may disclose your race, color, religion, national
    origin, ancestry, gender, or age.)

    Employment Record
    Please list all employment positions beginning with your present or most current job. Please complete all blanks.

    Most Recent Employment
    Name of Firm

    Address (Street, City, State)

    Phone

    Last Supervisor

    Job Title

    Employed From:     To:

    Starting Salary:     per:

    Ending Salary:     per:

    Specific Duties

    Reason for Leaving

    Prior Employment
    Name of Firm

    Address (Street, City, State)

    Phone

    Last Supervisor

    Job Title

    Employed From:     To:

    Starting Salary:     per:

    Ending Salary:     per:

    Specific Duties

    Reason for Leaving

    Prior Employment
    Name of Firm

    Address (Street, City, State)

    Phone

    Last Supervisor

    Job Title

    Employed From:     To:

    Starting Salary:     per:

    Ending Salary:     per:

    Specific Duties

    Reason for Leaving

    Prior Employment
    Name of Firm

    Address (Street, City, State)

    Phone

    Last Supervisor

    Job Title

    Employed From:     To:

    Starting Salary:     per:

    Ending Salary:     per:

    Specific Duties

    Reason for Leaving

    Miscellaneous

    Verification of your legal right to work in the United States will be required after employment.
    Will you be able to supply such verification?*
    YesNo

    Have you ever been employed at Mountain View Mushroom Farms?*
    YesNo

    Have you made previous application to Mountain View Mushroom Farms?*
    YesNo

    Are you on a layoff or subject to recall with another employer?*
    YesNo

    If Yes, what company? When will recall rights cease?

    Have you been convicted of a crime which has not been annulled, expunged, eradicated or
    sealed by a court?*
    YesNo

    Have you ever been reprimanded or disciplined by a previous employer for violations of work
    or safety rules?*
    YesNo

    Have you ever been discharged by a previous employer?*
    YesNo

    If you answered yes to any of the last three questions above, please explain:

    Are you available for full time work?*
    YesNo

    Are you interested in temporary employment?*
    YesNo

    Are you willing to work over 8 hours a day if the job requires it?*
    YesNo

    Mountain View Mushrooms operates day and night shifts, seven days a week. Are you
    available for work any time?*
    YesNo

    Include information relative to change of name, nickname, and assumed name, to enable a
    check on your work.

    Other Information

    To assist us in further evaluating your qualifications for a position at Mountain View Mushroom Farms, the additional space provided below is for your use in explaining your response to previously asked questions and in describing your job related capabilities and career interests.

    I hereby certify that the information contained in this application is true to the best of my knowledge, and agree to have any of the statements checked by Mountain View Mushrooms unless I have indicated to the contrary.