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 No. _______________Birth date ____________________Social Security No._________________________
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 _______
Have you worked with draft animals? Yes _______No _______ Have you tended livestock? Yes _______No _______
Are you skilled in sustainable agriculture? Yes ______No _______ Can you operate a back hoe ? Yes _______ No _______
Do you have computer skills? Yes _______No _______ Can you use 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 _______
Do you have masonry skills? Yes _______No _______ Do you have carpentry skills? Yes _______No _______
Do you have any electrical 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 _______ Do you have skill laying tile? Yes _______No _______
Do you have any architectural skills? Yes _______No _______ Do you have forestry skills? Yes _______No _______
Can you repair diesel machinery? Yes _______ No _______ Can you repair small engines? Yes _______No _______
Please elaborate on your skills:
_____________________________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
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 & heavy machinery, spraying pesticides and fertilizers, building and maintaining farm buildings, performing
hard & strenuous physical labor, transporting and delivering produce, running errands off the property, working unusually long
hours, working weekends if needed, 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.
I understand, also, that the Garden Harvest Inc., its Executive Director, and its Farm Managers have the right to hire,
dismiss, direct, and schedule employees and that 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 _______
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?___________________________________