* are required items

Personal
Last Name *
First Name *
Middle Name
Present Address *
City *
State *
Phone *

123-456-7890
Are you of legal age to work?
Yes No 		Position(s) applied for?
Were you previously employed by us?
Yes No 		If yes, when?
If you are not a citizen of the United States, do you have permission to work in this country?
Yes No
If your application is considered favorably, on what date will you be available for employment?

MM/DD/YYYY
If part time, days and hours available
Salary expected
Have you ever been convicted of a felony?
Yes No 		If yes, explain
Have you even been bonded?
Yes No 		If you are applying for a
position requiring driving, do
you have a valid operator's or commercial driver's license (CDL)
Yes No 		If yes, which license
State
Date issued

MM/DD/YYYY

Education (Select year completed)
Elementary School
High School
College
School Attended
School Attended
School Attended

Military Service
Date entered
Date discharged
Branch of Service
Applicable Skills Learned

Character References

(Give persons you know well, not previous employers or relatives)
Name Address
(Street, City, State) 		Phone Number Occupation No. of Yrs.
Person has known you

Employment History
Name and Address of Employer Employed
From / To 		Kind Of Work Reason For Leaving Weekly Earnings
Name Of Firm *

Address

Supervisor *
Last

Start
Last

Start
Name Of Firm

Address

Supervisor
Last

Start
Last

Start
Name Of Firm

Address

Supervisor
Last

Start
Last

Start
Have you worked with farm equipment?
Yes No 		Do you have a farm background?
Yes No
Have you worked for other dealers?
Yes No 		What line?
Have you had experience with light-industrial equipment?
Yes No 		As an operator?
Yes No
Have you worked for other dealers?
Yes No 		What line?
Have you had experience with outdoor power equipment?
Yes No 		As an operator?
Yes No
Have you worked for other dealers?
Yes No 		What line?

Actual Experience In Any Of The Following
(Please check all that apply)

Office

Bookkeeper
Cashier
Data Entry Operator
File Clerk
Office Manager
Secretary-Stenographer

Other

Building Maintenance
Carpenter
Janitor
Watchman

Parts Department

Parts Clerk
Parts Inventory Control
Parts Manager

Sales Department

Auto Sales
Farm Machinery Sales (New)
Farm Machinery Sales (Used)
Light Industrial Equipment Sales
Outdoor Power Equipment Sales
Sales Manager
Truck Sales

Service Department

Diesel Mechanic
Electrician
Electronics
Farmstead Mechanization Technician
Hydraulics Mechanic
Implement Mechanic
Machine Set-up
Painting
Refrigeration
Service Manager
Shop Foreman
Small Engine Mechanic
Tractor Mechanic
Truck Driver
Welding
Are there any other experiences, skills, or qualifications which will be of special benefit in the job for which you are applying?
SPECIAL NOTE - PLEASE READ CAREFULLY

The facts set forth in my application for employment are true and complete. I understand that if employed, false statements on this application shall be considered sufficient cause for dismissal. You are hereby authorized to make any investigation of my personal history and financial and credit record through any investigative or credit agencies or bureaus of your choice. I also give permission to contact employers listed on the reverse concerning work experience.


In making this application for employment, I authorize you to make an investigative consumer report whereby information is obtained through personal interviews with my neighbors, friends, or others with whom I am acquainted. This inquiry, if made, may include information as to my character, general reputation, personal characteristics and mode of living. I understand that I have the right to make a written request within a reasonable period of time to receive additional, detailed information about the nature and scope of any such investigative report that is made.


After employment, applicant agrees to comply with the Immigration Reform and Control Act of 1986, which required proof of citizenship or alien status within three days of employment.


SIGNATURE OF APPLICANT

Please sign this form as proof of your electronic signature. *

Since Federal, State and Local laws and interpretations of them change frequently, National Farm & Power Services, Inc. and any of its affiliates disclaim compliance with such laws. Users should refer any legal questions regarding this form to their legal counsel.


This employment application is prepared for general use by equipment dealers and is intended to comply with all federal, state and local fair employment practices law and with the Fair Credit Reporting Act.


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Mail applications to:
Mankato Implement
1150 S Victory Dr
Mankato, MN 56001