Application for Salaried Management

Date of Application

Personal Information

First name*

Middle initial*

Last name*

Social security number*

Date of birth*

Driver's license number*

State driver's license issue in*

Phone*

Email address*

Address*

City & state*

Zip*

General Information

Date of Availability

Are you a U.S. citizen? YesNo

If no, are you legally eligible to work in the United States?
YesNo

Position you are applying for?
Manager

Salary/Hourly wage expected

Have you ever been convicted of a felony or misdemeanor within the last 7 years? YesNo

If yes, please explain?

High School Education

Select the highest grade completed
9101112GED

School name

City & state

College Education

Select the highest grade completed
none1234

School name

City & state

Major

School diploma, degree, or certificate earned

Please list degrees, certifications, seminars attended, etc...

Employment History

Please give us accurate and complete employment history including full-time, part-time, contract, self-employment, military service and periods of unemployment. Start with your most recent employer. Referencing a resume is not acceptable.

Employer #1

Company name

City & state

Phone

Job title, duties and responsibilities

Reason for leaving

Dates of employment

Wage or salary

Other compensation (OT, bonuses, allowances)

Employer #2

Company name

City & state

Phone

Job title, duties and responsibilities

Reason for leaving

Dates of employment

Wage or salary

Other compensation (OT, bonuses, allowances)

If employed, may we contact your present employer?
YesNo

Applicant's Statement

I certify that answers given herein are true and complete to the best of my knowledge. I understand that any misrepresentation or omission of a material fact may be cause for cancellation of this application or immediate dismissal. I agree that Porkchop Hill Farms, Inc and any affiliates shall not be liable in any respect if my employment is terminated because of false statements, answers, or omissions made by me on this application.

I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision. I understand that I may be asked to submit to a background investigation and if so required, I must satisfactorily pass such test.

I understand that Porkchop Hill Farms, Inc. may procure a background check on me. I also understand that I have the right to request information regarding the scope and nature of the report.

This application for employment shall be considered active for a period of time not to exceed 180 days. If I wish to be considered for employment beyond this time period, I should inquire as to whether or not applications are being accepted at this time.

I HEREBY UNDERSTAND AND ACKNOWLEDGE THAT, IF HIRED, MY EMPLOYMENT WITH PORKCHOP HILL FARMS, INC. WOULD BE OF AND "AT-WILL" NATURE, WHICH MEANS THAT I MAY RESIGN AT ANY TIME AND FOR ANY REASON AND PORKCHOP HILL FARMS, INC. MAY DISCHARGE ME AT ANY TIME AND FOR ANY REASON. IT IS FURTHER UNDERSTOOD THAT THIS "AT-WILL" EMPLOYMENT RELATIONSHIP MAY NOT BE CHANGED BY WRITTEN DOCUMENT OR BY CONDUCT UNLESS AN AUTHORIZED EXECUTIVE OF THIS COMPANY SPECIFICALLY ACKNOWLEDGES SUCH CHANGE IN WRITING.

Authorization

I understand and give my permission to release any and all information from your files as permitted by law pertaining to Driving Records, Law Enforcement and Public Court Records, Credit Records, Employment and Education Records.

Release of Libility

I hereby forever release and discharge Porkchop Hill Farms, Inc. and its officers, directors, shareholders, agents and employees, as well as successors, assigns and all other persons acting on its behalf, from any claims, liability, action for damages compensation or otherwise, known or unknown, on account of or arising out of the investigation and disclosure of the requested information.

I further release and discharge all liability from all companies, agencies, officers, officials, employees, and person providing good faith, pertinent information an/or records as requested to successfully complete a background check for my application of employment.

By clicking this checkbox, you agree to the Terms above. Please read carefully.