Careers

Introductory Information

Name

Date

Address

City

State

Zip

Phone

Applicant Questions

Type of work desired:

Salary desired

Date available

If hired, can you provide documents required to establish your eligibility to work in the U.S.? Yes No

Are you 16 years of age or older? Yes No

How were you referred to Border Ag?

Have you ever been convicted of or pled guilty or no contest to a crime, other than a minor traffic violation? Yes No

If yes, please explain in detail below and include the date of final disposition of the case and the
nature of the offense. This information will not necessarily disqualify you from employment but false or misleading
information will. Factors such as age and time of the offense, seriousness and nature of the violation, and rehabilitation
will be taken into account.

Education

High School of last grade completed:

Name & Address of School

Course of Study

Number of Years Completed

Degree/Diploma

College or Technical School

Name & Address of School

Course of Study

Number of Years Completed

Degree/Diploma

Other Schooling or Training

Name & Address of School

Course of Study

Number of Years Completed

Degree/Diploma

Military Experience

Branch of Service

From

To

Rank/Type of Service

Job-Related Training/Experience

Record of Employment

List positions starting with most recent

Employer

Telephone

Address

Position Title

Supervisor

Start Date

Date Left

Beginning Salary

Ending Salary

Duties

Reason for Leaving

Employer

Telephone

Address

Position Title

Supervisor

Start Date

Date Left

Beginning Salary

Ending Salary

Duties

Reason for Leaving

Employer

Telephone

Address

Position Title

Supervisor

Start Date

Date Left

Beginning Salary

Ending Salary

Duties

Reason for Leaving

Work-Related References (Do not include relatives)

Name

Occupation

Years Known

Contact Information

Name

Occupation

Years Known

Contact Information

Name

Occupation

Years Known

Contact Information

STATEMENT (Please read this statement carefully before submitting this application):

I understand that employment with Border Ag is at-will, meaning that I or Border Ag may terminate my employment at any time, or for any reason consistent with applicable state or federal law. I authorize Border Ag to conduct a thorough background investigation of my work and personal history, and verify all data given on this application and during interviews. I hereby release Border Ag, and its representatives or agents, from any liability that might result from such an investigation. I authorize all individuals, schools, and firms named to provide any requested information and release them from all liability for providing the requested information.

I understand this application will be active for a period of 90 days; after that time, if I wish to be considered for employment, I must submit a new application. I certify that all the statements in this completed application are true and understand that any falsification or willful omission shall be sufficient cause for dismissal or refusal to hire.

I understand this application will be active for a period of 90 days; after that time, if I wish to be considered for employment, I must submit a new application. I certify that all the statements in this completed application are true and understand that any falsification or willful omission shall be sufficient cause for dismissal or refusal to hire.

I agree to the above