Maple Leaf Farms - APPLICATION FOR EMPLOYMENT

An Equal Opportunity Employer

PERSONAL INFORMATION

Incomplete information could disqualify you from further consideration.

Today's Date

First Name

Last Name

Address

City

State

Zip Code

Email

Cell Phone

Home Phone (if different from Cell)

Are you eligible to work in the U.S.? YesNo

Are you at least 18 years or older? YesNo

During the last ten years, have you ever been convicted of a crime other than minor traffic offense?

A Conviction will not necessarily automatically disqualify you for employment. Rather, such factors as age and date of conviction, seriousness and nature of crime, and rehabilitation will be considered.

YesNo

If yes, please provide details

(dates and location for all convictions)

Have you ever been terminated from employment or asked to resign by an employer? YesNo

If yes, please provide company names and details

Can you work any shift? YesNo

Can you work overtime, including weekends? YesNo

Are you able to perform the essential functions of the job for which you are applying, with or without a reasonable accommodation? YesNo

General Labor Application

Maple Leaf Farms - APPLICATION FOR EMPLOYMENT

An Equal Opportunity Employer

PERSONAL INFORMATION