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? ___________________________________