Employment Application

Personal Information

Your Name:*

First Last

What do you prefer to be called?

Please tell us how you found this page:

If you were referred to us by a current employee, please provide their name here:

Home Address:*

(where we will send you a year-end W-2)

Street Address Address Line 2 City State ZIP Code

Primary Phone Number:*

Cell Phone Number:*

Do you accept text messages?

Yes
No

Your Email:*

Emergency contact person & their primary phone number:*

Are you legally eligible for employment in the United States?

Yes
No

Have you ever been convicted of a felony crime?

NOTE: Applicants are not obligated to disclose sealed or expunged records of conviction or arrest, nor expunged juvenile records.

Yes
No

Please explain:

Your Availability

The following questions are designed to help us determine where you would be the best fit at Curtis Orchard.

What is the minimum number of hours per week you are willing to work?*

What is the maximum number of hours per week you are willing to work?*

What is your availability between 7 am and 7 pm in the fall on each day of the week?*

Please list all fall commitments that may cause you to ask for time off, such as classes, other employment, or extracurricular activities.

Have you ever worked here before?*

Yes
No

If so, when?

Can you lift more than 25 pounds?

Yes
No

Can you stand for a long time?

Yes
No

Can you stoop or bend without any problems?

Yes
No

Are you at least 16 years old?

Yes
No

Are you at least 18 years old?

Yes
No

NOTE: We ask this because you must be 18+ to operate machinery.

More About You

The following questions help us determine where you would be the best fit at Curtis Orchard. Click the answer that is most appropriate for each of the following statements. (There are no right or wrong answers; we hire people at every preference level.)

Rate how much you like working indoors:

I really like working indoors
I sort of like working indoors
I am indifferent about working indoors
I prefer to not work indoors, but will when needed
I do not like working indoors at all

Rate how much you like working outside:

I really like working outside
I sort of like working outside
I am indifferent about working outside
I prefer to not work outside, but will when needed
I do not like working outside at all

Rate how much you enjoy working around the public:

I really like working around the public
I sort of like working around the public
I am indifferent about working around the public
I prefer to not work around the public, but will when needed
I do not like working around the public at all

Rate how much you enjoy working behind-the-scenes:

I really like working behind-the-scenes
I sort of like working behind-the-scenes
I am indifferent about working behind-the-scenes
I prefer to not work behind-the-scenes, but will when needed
I do not like working behind-the-scenes at all

Rate how much you enjoy working in a team versus by yourself:

I thrive working in a team, but not by myself
I am indifferent about working in a team or by myself
I thrive in a team and by myself as well
I thrive working by myself, but not in a team

Rate how much you like working around children versus adults:

I enjoy working with kids, but not with adults
I am indifferent about working with kids or adults
I enjoy working with kids and with adults as well
I enjoy working with adults, but not with kids

Which departments/jobs are you most interested in working in? (select all that apply)

Click here for more information on the jobs listed below (opens in a new window)

If you answered "Other" please explain:

Besides enjoying your experience here as a customer, are there any other reasons why you'd like to work at Curtis Orchard?

Education

Name of most recent school attended and its town / city.

Still attending?

Yes
No

How many years have you completed?

Employment Experience

Please list your last two employers below, starting with your present, or most recent, employer. Please give accurate and complete full-time, part-time, and military experience.

Employer #1

Company Name	Employment Dates (month and year)	Company Phone Number	Your Position

Name/Title of Your Supervisor

Reason for Leaving

Describe Your Work Duties

Employer #2

Company Name	Employment Dates (month and year)	Company Phone Number	Your Position

Name/Title of Your Supervisor

Reason for Leaving

Describe Your Work Duties

Is there any other work experience (agricultural or otherwise) you wish to include?

I hereby acknowledge that the information provided in this application of employment is true and complete.*

Yes

I authorize investigation of all statements contained on this application.*

Yes

I understand that acceptance of an offer of employment does not create a contractual obligation upon the employer to continue to employ me in the future.*

Yes

If employed, I understand that any misstatement or omission of fact on this application may result in my dismissal, and that Curtis Orchard reserves the right to require an employee to submit to random testing for drug and/or alcohol use as a continuing condition of employment as Curtis Orchard deems necessary to ensure the safe and efficient operation of the business.*

Yes

If hired for weekends, I acknowledge that, unless disclosed during the interview and approved, I am required to work every Saturday and Sunday during September and October.*

Yes

Signature*

If we invite you to join Curtis Orchard this fall, you will also be required to provide your signature on a printed copy of this application.

Phone

This field is for validation purposes and should be left unchanged.

Thank you for your interest in being a part of our team!

Personal Information

Your Availability

More About You

Education

Employment Experience