GARDEN HARVEST, INC.

14045 MANTUA MILL  RD.

GLYNDON, MD. 21071

(410) 526-0698

FAX: 866-362-3644 (TOLL FREE)

garharvest@aol.com

 

 

 

APPLICATION FOR EMPLOYMENT

 

PERSONAL DATA:

 

Name_____________________________________________________________________________________________

 

Home Phone Number _________________­_ Cell Phone Number _________________Birth date _______________________

 

Social Security No._________________________ Number of Dependents you would be Claiming ________

 

Present Address________________________________________________________________________________________

 

In case of Emergency, please notify: _______________________________________________Phone______________________

 

Drivers License No._______________________________________________State________Class________Expires_________

 

Has your license ever been suspended or revoked in any State? Yes _______No _______

 

                If yes, indicate which state, date, and reason: _______________________________________________________

 

Do you own your own transportation? Yes _______No _______ Do you own your own home? Yes _______No _______

 

Do you regularly exercise? Yes _______ No _______ Are you capable of hard physical labor? Yes _______No _______

 

Are you a vegetarian? Yes _______ No _______ Are you active in preserving the environment? Yes _______ No _______

 

Do you smoke? Yes _______ No _______ Are you allergic to bee stings? Yes _______ No _______

 

Are you allergic to Poison Ivy? Yes _______ No _______ Are you allergic to pollen? Yes _______ No _______

 

Physician________________________________________Address___________________________________________

 

 Have you ever collected Workman's Compensation? Yes _______No _______

 

                If so, explain_______________________________________________________________________________

 

 

Were you in the US Armed Forces? Yes _______No _______ What Branch? __________________________________

 

Rank at Discharge ________________________________Type of Discharge___________________________________

 

Dates of Duty   From_____________________________________To_________________________________________

 

List duties in the Service, including special training__________________________________________________________

 

_________________________________________________________________________________________________

 

EDUCATIONAL DATA:

 

Did you successfully complete?

 

                Elementary School Yes _____No _____ Junior High Yes _____No _____ Senior High Yes _____No _____

 

                Bachelor's Degree Yes _____No _____ Master’s Degree Yes ____No _____ Doctorate Yes _____No _____

 

If you did not graduate from High School, have you received a State high school equivalence certificate? Yes ____No _____

 

Give name and location of College, University, or Professional School___________________________________________

 

______________________________________________________________________________________________

 

 

 

 

 

REFERENCE DATA

 

Personal References (unrelated persons)

 

Name_____________________________________________________Years Known__________________

 

Address__________________________________Phone No.____________________

 

Occupation_________________________________

               

Name___________________________________________________Years Known__________________

 

Address__________________________________________________Phone No.____________________

 

Occupation_________________________________

 

               

Name_____________________________________________________Years Known__________________

 

Address____________________________________________________Phone No.__________________

 

Occupation_________________________________

 

 

Societies, Clubs, or Affiliations

 

_________________________________________________________________________________________________

_________________________________________________________________________________________________

 

 

 

EXPERIENCE DATA

 

Have you done farm work? Yes _______No ____ Have you ever worked for a non-profit? Yes _______No _______

 

Do you have experience working with horses? Yes ____No _____Have you tended sheep? Yes _______No _______

 

Are you skilled in sustainable agriculture? Yes _____No _____ Can you operate a backhoe? Yes _______ No _____

 

Do you have computer skills? Yes _____No _____ Are you skilled at using a chain saw? Yes _____No _______

 

Can you drive a farm tractor? Yes _____No _____ Do you consider yourself a good cook? Yes _____No ______

 

Have you ever done fundraising? Yes _____No ______Do you have landscaping experience? Yes_____ No______

 

Are you comfortable supervising others? Yes _____No _____ Do you mind working alone? Yes _______No _____

 

Have you ever worked with bees? Yes _____No _____ Do you know how to prune fruit trees? Yes _____No ___

 

Are you a skilled carpenter? Yes _____No ______ Do you know how to use a circular saw? Yes _____No _______

 

Do you know how to use a nail-gun? Yes ____ No _____ Can you safely wire an electrical box? Yes _____No _____

 

Do you have any masonry skills? Yes _____No _____ Do you have any plumbing skills? Yes ______No ______

 

Can you hang dry wall? Yes _____No _____ Do you have skills working with concrete? Yes _____No _______

 

Do you have any roofing skills? Yes _______No _______ Are you skilled at tile-work? Yes _______No _______

 

Do you have any architectural skills? Yes _____No _____ Do you have engineering skills? Yes _______No _______

 

Can you repair diesel machinery? Yes _______ No _______ Can you repair small engines? Yes _______No _______

 

Can you change spark plugs? Yes _______ No _______ Can you change engine oil? Yes _______ No _______

 

Please list any skills not mentioned above________________________________________________________________

________________________________________________________________________________________________

 

 

 

EMPLOYMENT HISTORY

 

Give employment record as completely as possible starting with your present or last employer not to exceed past 15 yrs.

 

 

Company Name__________________________________________________Supervisor__________________________

 

Address________________________________________________________Phone No.__________________________

 

Type of Business_________________________________________Full time ______Part Time________

 

Date began ____________Date left _____________Salary Start _______________Salary Finish________________

 

Position___________________________Duties___________________________________________________________

 

Reason for leaving__________________________________________________________________________________

 

 

Company Name__________________________________________________Supervisor__________________________

 

Address________________________________________________________Phone No.__________________________

 

Type of Business____________________________________________Full time ______Part Time________

 

Date began _____________Date left ____________Salary Start _______________Salary Finish________________

 

Position___________________________Duties___________________________________________________________

 

Reason for leaving__________________________________________________________________________________

 

 

Company Name__________________________________________________Supervisor__________________________

 

Address________________________________________________________Phone No.__________________________

 

Type of Business_________________________________________________Full time ______Part Time________

 

Date began ____________Date left ____________Salary Start _______________Salary Finish________________

 

Position___________________________Duties___________________________________________________________

 

Reason for leaving__________________________________________________________________________________

 

 

Company Name__________________________________________________Supervisor__________________________

 

Address________________________________________________________Phone No.__________________________

 

Type of Business__________________________________________Full time ______Part Time________

 

Date began ____________Date left ______________Salary Start _______________Salary Finish______________

 

Position___________________________Duties___________________________________________________________

 

Reason for leaving__________________________________________________________________________________

 

 

Company Name__________________________________________________Supervisor__________________________

 

Address________________________________________________________Phone No.__________________________

 

Type of Business______________________________________________Full time ______Part Time________

 

Date began ____________Date left ___________Salary Start _______________Salary Finish________________

 

Position___________________________Duties___________________________________________________________

 

Reason for leaving__________________________________________________________________________________

 

 

 

 

JOB DESCRIPTION &  AGREEMENT

 

               

I understand that to work for Garden Harvest, Inc. is to perform farm work, which includes but is not limited to: using power equipment and heavy machinery, spraying organic pesticides and fertilizers, building and maintaining farm buildings, performing hard and strenuous physical labor, transporting and delivering produce, working with farm animals, cleaning chicken coops,  running errands off the property, working unusually long hours, supervising volunteers, cooking meals, office work, working with bees, digging, planting, weeding, harvesting, and performing any and all tasks associated with the running of a farm. Also, I understand that working on the farm may expose me to poison ivy, pollen, bees and ticks that carry Lymes Disease.

 

I understand that Garden Harvest Inc., its Executive Director, and its Farm Managers have the right to hire, direct, schedule, and dismiss employees and due to the nature of the work, there will be days I do not work. This employment is temporary and I may be dismissed at any time. Please initial ____________

 

 

AVAILABILITY

 

Do you have any impairment, physical, mental, or medical, which would prevent you from performing in a reasonable

 

manner the activities involved in the job or occupation for which you have applied? Yes _______ No _______

 

Could you work Saturdays if needed? Yes _____No _____ Could you work Sundays if needed? Yes _____No _____

 

Are there any days that you already have plans for and are planning to miss? Please list_________________________________

 

______________________________________________________________________________________________________

 

How soon could you  report to work? ________________________________________

 

 

 

CONCLUSION

 

                I authorize Garden Harvest, Inc. to investigate any and all statements made in this application.  I also authorize my current or previous employers to verify the statements made in this application, and to provide other employment data relating to my job performance, as requested.  I authorize Garden Harvest, Inc. to contact my references.  .

               

                Falsification or misrepresentation of the information submitted on this application could result in the disqualification of the applicant from further consideration for employment, or if the applicant has been hired, could result in his/her discharge from employment. 

 

 

 

Date_______________________Signature________________________________________

 

May we contact your present employer? ___________________________________