LAD IRRIGATION COMPANY, INC.

Application for Employment

An Equal Opportunity Employer

Each question should be fully and accurately answered. No action can be taken on this application until all questions have been answered. All information given will be available only to persons who have a "need to know' or as required by law. This company will make reasonable accommodation in the application process, if needed.

This application is current only for thirty (30 days), at the conclusion of which time, if you have not heard from us and still wish to be considered for employment, it will be necessary fur you to fill out a new a application





Your Full Name

Today's Date

Present Address

Telephone #

Email

Position applied for?

When are you available for employment?

Which type of employment are you seeking?
 Full-time Part-time Temporary or Summer

Record of Employment

Employer 1

1. Name of Current/Most Recent Employer

Employer's Address

Type of Business

Telephone #

Dates Employed:
From
To

Rate of Pay:
Starting
Ending

Reason For Leaving

Supervisor's Name and Title

List the jobs you held, duties performed, skills used or learned, advancements, or promotions.

May we contact this employer?  Yes No

Employer 2

1. Name of Next Previous Employer [text*emp2]

Employer's Address

Type of Business

Telephone #

Dates Employed:
From
To

Rate of Pay:
Starting
Ending

Reason For Leaving

Supervisor's Name and Title

List the jobs you held, duties performed, skills used or learned, advancements, or promotions.

May we contact this employer?  Yes No

Employer 3

1. Name of Current/Most Recent Employer

Employer's Address

Type of Business

Telephone #

Dates Employed:
From
To

Rate of Pay:
Starting
Ending

Reason For Leaving

Supervisor's Name and Title

List the jobs you held, duties performed, skills used or learned, advancements, or promotions.

May we contact this employer?  Yes No

Employer 4

1. Name of Next Previous Employer

Employer's Address

Type of Business

Telephone #

Dates Employed:
From
To

Rate of Pay:
Starting
Ending

Reason For Leaving

Supervisor's Name and Title

List the jobs you held, duties performed, skills used or learned, advancements, or promotions.

May we contact this employer?  Yes No

Have you been convicted of a felony during the last 7 years or convicted of any other offense during the last 2 years? (A conviction will not necessarily disqualify an applicant.)
 Yes No

If yes, please explain.

Are you over 18 years of age?  Yes No

Are you authorized to work in the United States? (Federal Law requires proof of identity and employment authorization for all new employees.)  Yes No

For Driving Job Only: Do you have a valid driver's license?  Yes No

License Number and State Issued:

EDUCATION (Select last year completed)

High School  1 2 3 4 School Name Major Subjects

College  1 2 3 4 School Name Major Subjects

Other job-related education or Trade School  1 2 3 4 School Name Major Subjects

If you are an experienced operator of any business/plant machines or equipment, please list:

Other job related skills:

Please Upload Your Cover Letter (PDF or TXT files only):

Please Upload Your Resume (PDF or TXT files only):

This Employment Application is used to notify me that the nature and scope of an investigation, if one is conducted, could include such general identification information as residence verification, and, as applicable, information concerning my employment, education, general reputation, character, personal characteristics, and habits, and that such information may be developed through personal interviews with third parties such as family members, neighbors, friends, associates, former employers, educational institutions, custodians of official records or other sources. Only job-related information developed from such a report will be considered in evaluating my employment application or continued employment. I hereby authorize these persons, companies, organizations, or corporations to answer all questions, or release any information regarding the items listed in this paragraph. I hereby release them from any liability and hold them harmless from any claim for releasing any truthful information within their knowledge and/or records.

I authorize the Company to release to any person, firm, entity, or organization with which I may seek employment in the future, any truthful information concerning my work experience with the Company. I hereby release and hold the Company harmless from any claim for releasing any truthful information within its knowledge and/or records.

I understand that any job offer that may be extended to me will be contingent upon the successful completion of a drug and alcohol test. I certify that the answers given by me to the foregoing question and during any interviews are true and correct without consequential omissions, and understand that, if employed, omissions and/or false statements on this application or during any interviews may result in dismissal. I understand and acknowledge that, if hired, my employment is for no definite period of time, and either the Employer or I may terminate our relationship at will at any time, without notice or any reason, and that this employment application does not constitute an employment contract. I have had an opportunity to have my questions about this statement's content and intent answered and understand its terms.

Date:
Applicants Name: