Career Application Form – Caledonia Farmers Elevator

Employment Application

All About You

This section inquires as to basic personal information relevant to employment consideration.

First Name

Middle Name

Last Name

Street Address

Address Line 1

Address Line 2

City

State

Zip Code

Cell Phone

Are you 18 years or older?

Yes

Are you authorized to work in the U.S.?

Yes

What languages do you speak?

Please list the other language(s) you speak.

What languages do you read & write?

Please list the other language(s) you read & write.

Do you have a valid driver's license?

Yes

Please select all types of valid driver's licenses you currently hold.

Have you ever been denied a license or permit to operate a motor vehicle?

Yes

Do you have reliable transportation to & from work?

Yes

No, I need special accommodations

Are you currently employed?

Yes

Why are you looking for a different job?

Have you been previously employed at CFE?

Yes

Please list the department you were employed in.

Please select your former CFE employment start date. If you are unsure, please list the nearest approximate date.

Please select your former CFE employment end date. If you are unsure, please list the nearest approximate date.

Under what name were you formerly employed with CFE? First name here.

Last name here.

If applicable, please list any relatives or friends currently working for CFE.

Service to our Country

This section inquires about military service.

Are you, or have you ever been a member of the Armed Forces of the USA or in a state National Guard?

Yes

Thank you for your service! Please list your date of discharge. If you are unsure, please list the nearest approximate date.

Are you in the reserves of any military branch?

Yes

Thank you for your service! On what date does your obligation to the reserves end?

Please list the duties you performed while enlisted.

What You're Hoping For

In this section, we'll inquire as to your expectations and desires for employment with us.

What position(s) are you looking for with us?

What sort of employment are you primarily seeking?

Full-time

Part-time

Temporary

Temporary Employment Desired Start Date

Temporary Employment Desired End Date

What is your wage/salary expectation? Please specify whether this figure is hourly or salaried.

Is there any day/time of the week you are not available to work?

What primarily motivates you? You may select multiple.

What is your location preference? You may select multiple if applicable, or you have no preference.

Skills & Certifications

In this section, please list any previous experience, special training, skills, or certification that relate to the position applied for.

For example, computer, Cash Register, Hi-lo, CCA, Commercial Applicator, Welding, etc.

Skills & Certifications Table

Certification or Skill	Certifying Entity	Expiration	Years Held

References

Please list three individuals, not related to you, that you have known for more than a year.

References Table

Name, City, & State	Contact (Phone or Email)	Relationship	Years Known

Experience

Note to driver candidates: The U.S. Department of Transportation requires that driver applicants show all employment for the past three years. They must also show commercial driver employment for the seven years immediately proceeding this three-year period.

ALL APPLICANTS: Start with last, or current employer, and work back. Please note if you do not want us to contact anyone listed below.

Experience Table

Employer, City & State, Phone	Years Employed	Position	Reason for Leaving

Education

Please describe the nature of your education.

Education Table

Name of School	State	Years Attended	Diploma/Degree Received

Applicant Agreement

Please read and acknowledge the section below.

I certify that all information I have provided on this application for employment is true and complete to the best of my knowledge. I authorize CFE representatives to investigate all information contained on this application. I understand that if selected for employment I will be required to complete pre-placement assessments including but not limited to a physical examination and drug screening.

I acknowledge the following: Caledonia Farmers Elevator Company is an equal opportunity employer that maintains an employment at-will policy permitting you or CFE to terminate the joint relationship at any time for any reason.

Please type your full name, as this will function as your signature to certify your acknowledgement of the above statement.

Please select today's date.

Are you applying for a driver position?

Yes

Driver Information

Since you've selected that you're applying for a driver position, you will need to complete the following sections.

Please note: Your MVR is a determining factor on our ability to offer you employment.

Do you have a valid driver's license?

Yes

License Expiration Date

Please enter your driver's license number.

What state was the license issued in?

What type of license(s) do you hold?

Please list any endorsements.

Do you have a current DOT Medical Card?

Yes

Have you had any moving violations in the last 3 years?

Yes

How many moving violations have you had in the last 3 years?

Have you ever been denied a license, permit, or privilege to operate a motor vehicle?

Yes

Accident Record for the last 3 years. If none, leave blank.

Date	Nature of Accident	Fatalities	Injuries

List of forfeitures for the last 5 years. If none, leave blank.

Forfeiture Date	Reinstatement Date	Charge

Please list driving experience for the last 7 years. Please note, class of equipment would refer to terms like: straight truck, semi/tractor, tandem, bus, other, and type of equipment would refer to terms like: van, flatbed, tank, other.

Class/Type of Vehicle	Start Date	End Date	Local or OTR

If you have additional files to upload such as a resume, cover letter, or additional documentation, you may do that here. Maximum of 5 files at less than 2MB Each. Accepted file formats: JPG, PNG, PDF, DOC/DOCX, XLSX.

Choose File(s)

Locations in: Caledonia | Lake Odessa | Charlotte | Richland